Long-Term Results of Mucosal Reconstruction Using Cultured Oral Epithelial Sheets

Objectives: Human amniotic membrane (AM), a thin intrauterine placental membrane is highly biocompatible, and possesses anti-inflammatory and anti-scarring properties. Using AM, we developed a novel method for cultivating oral mucosal epithelial cell sheets. We investigated autologous transplantation of oral mucosal epithelial cells on AM in patients undergoing oral surgeries. Methods: The protocol for this experiment was approved by the Human Studies Committee of Kyoto Prefectural University of Medicine (RBMR-R-19). Specimens of AM were obtained from women undergoing Caesarean section. The study included five patients with no history of any disorders and who underwent autologous cultured oral epithelial transplantation for oral surgical procedure. Using oral mucosal biopsy specimens obtained from the patients, oral epithelial cells were cultivated on an AM carrier. The resultant sheet was transplanted on the oral mucosal defect. All patients were followed up for more than 12 months after transplantation. Results: After 2–3 weeks of culture, the cultivated epithelial cells seemed well differentiated and showed stratification into 5–7 layers on AM. Immunohistochemistry demonstrated that the cultivated cells expressed highly specific mucosal epithelial cell markers and basement membrane proteins. After the surgical procedure, the reconstructed sites did not show infection, bleeding, rejection, or sheet detachment, and the sites achieved a new oral mucous membrane. In the long-term follow-up of more than 12 months, neither contracture nor recurrence was detected, and the postoperative course was excellent. Conclusions: In view of these finding, this oral AM-cultured epithelial sheet might be a useful biomaterial, and a feasible method for oral mucosal reconstruction.