자가이식을 위한 지표로써 입천장 씹기점막의 두께

Abstract

The palatal masticatory mucosa is widely used the donor site for periodontal plastic surgery and posterior lamellar reconstruction of the eyelid. The purpose of this study was to measure the thickness of palatal masticatory mucosa and to assess the histologic characteristic with reference to the autogenous graft. Ten cadaver heads (20 hemi-maxillae) with normal teeth were examined (8 male and 2 female, median: 59.3 years). These maxillae were decalcified and sectioned at interdental line from canine to 2nd molar perpendicular to midpalatal suture. The thickness of palatal masticatory mucosa was assessed at 24 standard measurement points defined according to the cementoenamel junction and midpalatal suture using a periodontal probe. And then the sectioned specimens were processed for embedding in paraffin and were stained with haematoxylin-eosin (H&E). The mean thickness of palatal masticatory mucosa according to tooth site was 3.73 ± 1.19 ㎜ (canine distal), 3.65 ± 1.11 ㎜ (first premolar distal), 3.46 ± 1.11 ㎜ (second premolar distal), 2.93 ± 1.08 ㎜ (first molar midline), 2.98 ± 1.11 ㎜ (first molar distal), and 3.24 ± 1.86 ㎜ (second molar distal), with the thinnest area at the first molar midline region. And they increased from the cementoenamel junction towards midpalatal suture, with 2.40 ± 0.85 ㎜ (3 ㎜ under the cementoenamel junction), 2.75 ± 0.82 ㎜ (6 ㎜), 3.63 ± 1.05 ㎜ (9 ㎜), and 4.51 ± 1.29 ㎜ (12 ㎜). On histologic features, the lamina propria decreased towards the posterior palatal area and mid palatal suture. In contrast, the submucosa which presents the glandular and adipose tissue increased towards the posterior palatal area and mid palatal suture. These results suggest that the most appropriate donor site for gingival and posterior lamella repair is the 6 ㎜ to 9 ㎜ area under the cementoenamel junction on canine to premolar region.