Clinical Oral Investigations

, Volume 23, Issue 2, pp 957–964 | Cite as

Structural and histological differences between connective tissue grafts harvested from the lateral palatal mucosa or from the tuberosity area

  • I. Sanz-MartínEmail author
  • E. Rojo
  • E. Maldonado
  • G. Stroppa
  • J. Nart
  • M. Sanz
Original Article



Tuberosity grafts had a greater percentage of lamina propria and lower percentage of submucosa when compared to lateral palate grafts.


The study aims to understand the differences in the structural composition of soft tissue autografts harvested from the lateral palate or the tuberosity.

Material and methods

Patients were randomly allocated to receive autografts harvested either from palatal or tuberosity sites to augment horizontal volume deficiencies around single-tooth implants. Tissue biopsies were analyzed for histological and histo-morphometric analysis. Picro-sirius red stain was used to evaluate collagen 1 and 3. Also, immuno-histochemical analysis was performed against MMP1, MMP2, cytokeratin-10, cytokeratin-13, and lysine hydroxylase-2.


Twenty specimens were harvested from 9 subjects in the lateral palate group (PG) and 11 subjects in the tuberosity group (TG). The percentage of lamina propria represented 51.08% in the PG group and 72.79% in the TG group, while the area of submucosa was minimal in the TG group representing 4.89% of the total sample vs 25.75% in the PG. The total area of COL-1 and 3 in the TG was 1.19 ± 0.57 and 0.72 ± 0.44 mm2, respectively, while in the PG, the corresponding values were 1.4 ± 0.7 and 1.04 ± 0.5 mm2. The immuno-histochemical analysis generally showed a higher expression of LLH-2, MMP2, CYT-10, and CYT-13 in the TG when compared with the PG.


Tuberosity grafts had a greater percentage of lamina propria and lower percentage of submucosa. The collagen content in the lamina propria was similar for both groups while the immuno-histochemical profile showed differences in the antibody expression of the epithelial cells.

Clinical relevance

Tuberosity grafts had more lamina propria and less submocusa, which may be beneficial for volume augmentation.


Histology Connective tissue Soft tissue Soft tissue graft Dental implants Palate 



The study was partially funded by a Young Researcher Grant (14–114) from the Osteology Foundation, Lucerne, Switzerland.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethic approval was obtained from the regional ethical committee (PER-ECL-2011-10-NF). The present investigation was registered in with the reference NCT03090906.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • I. Sanz-Martín
    • 1
    • 2
    Email author
  • E. Rojo
    • 2
  • E. Maldonado
    • 1
  • G. Stroppa
    • 2
  • J. Nart
    • 2
  • M. Sanz
    • 1
  1. 1.Section of Periodontology, Faculty of OdontologyUniversity Complutense of MadridMadridSpain
  2. 2.Department of PeriodontologyUniversitat Internacional de Catalunya (UIC)BarcelonaSpain

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