The Histology of Autologous Skin Grafts in the Human Oral Cavity

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Abstract
Investigations have been made in order to follow histologically the healing process of split skin grafted to the oral cavity. the material was obtained from 28 female and 4 male patients having received preprosthetic surgery due to an atrophic lower alveolar process. Biopsies were taken from the junctional area between the graft and the oral mucosa 10 days, 1, 3, 6, and 12 months postoperatively. After 10 days there was a distinct hyperplasia of the grafted epidermis. the junction between the epidermis and the oral epithelium were clearly defined as a change from orthokeratosis in the epidermis to slight parakeratosis in the oral epithelium. the hyperplasia were in most cases still present in the 12 months specimens. Some, however, showed a normal or even atrophic epidermis after 6 months. the junction between the oral epithelium and grafted epidermis could be clearly demonstrated 12 months postoperatively. In the connective tissue only a moderate inflammatory reaction were present throughout the period examined. No elastic fibres were formed in the junctional area making the transition between graft and oral mucasa easy identifyable. In 6 patients infection with candida albicans developed in the graft probably caused by the antibiotic treatment. Biopsies showed marked epithelial hyperplasia with parakeratosis and intraepithelial accumulations of leucocytes around candida hyphae. These changes are identical to those seen in oral leucoplakias with superimposed candida infection.