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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2009 April;20(1):21-9
Human amniotic membrane use in oral surgery: experimental study with in vitro tests and clinical application
Ruffino S. 1, Fornaseri C. 1, Rossi E. 1, Ungari S. 2, Maffè A. 2, Ginardi C. 2, Indemini P. 3, Sava A. L. 3, Caramello G. 3
1 Maxillo-Facial Surgery Head and Neck Department Azienda Ospedaliera S.Croce e Carle - Cuneo - Italy
2 Department of Molecular Biology Laboratory Department Azienda Ospedaliera S.Croce e Carle - Cuneo - Italy
3 Ophthalmology-Banca delle Membrane Amniotiche della Regione Piemonte Head and Neck Department Azienda Ospedaliera S.Croce e Carle - Cuneo - Italy
Aim. Because of its features human amniotic membrane (HAM) is a suitable tissue for lots of clinical applications: it has antiflogistic, antiadhesive, angiogenic and antibacterial properties, it stimulates re-epithelization and doesn’t cause any immune reaction in the host body, as it has been reported in many scientific papers. The aim of this study was to evaluate the potential use of HAM grafts in oral surgery to improve oral tissue repairs as an alternative to skin and mucosa grafts.
Methods. At first the authors studied the in vitro amnion cells proliferation, their production of growth factors and chemotactic agents that may be involved in engineering the oral tissue repair. These in vitro results demonstrated the ability of HAM cell cultures conditioned medium to increase oral epithelial cells proliferation (15% more) and epithelial cell motility (16% more) when compared to a conventional medium. Moreover the authors demonstrated the hepatocyte growth factor (HGF) presence in HAM cell cultures conditioned medium. The clinical study was run on 9 patients that needed surgery to remove fibrous hyperplasias in their vestibular fornixes: HAM patches were grafted on the residual areas.
Results. The follow-up showed the re-epithelization of the affected area and HAM disappearance after three weeks, while the surgery area was indistinguishable from the surrounding areas after three months.
Conclusion. The authors recommend HAM as an alternative graft material to skin or mucosa because of its advantages: an improved biological cost/benefit balance for the patient, an easier tissue handling, an easier adaptation to the graft area morphology and a wide availability.