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Clinical and Histological Features of Intraoral Flap and a Preliminary Study of DNA Methylation of Mucosalization

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Abstract

Flaps have been routinely used to reconstruct intraoral defects. Flaps after reconstruction tend to develop, with time, a mucosa-like appearance during a process called “mucosalization.” Many studies have described histological changes of mucosalization, but only a few of them mention the associated clinical factors. Our aim was to determine the possible predictive factors related to mucosalization of flaps employed for oral cavity reconstruction, and to verify whether skin inflammation-specific DNA methylation occurs in mucosalized flaps. In this study, 140 patients underwent reconstruction of the oral cavity defects with flaps, of which 39 showed “mucosalization” changes. Histological changes of “mucosalization” are characterized by inflammatory infiltration, accompanied by a reduction of thickness of the horny layer and elimination of skin appendages. These changes are affected by clinical differences with sex and type and site of flaps. We also found that DNA methyltransferase 1 was highly expressed in the epithelium of mucosalized flaps, and less in unmucosalized flaps, suggesting their involvement in the inflammation-dependent DNA methylation of mucosalization. To summarize, our results demonstrated that most intraorally placed flaps maintain skin features, except in the event of heavy inflammation. Mucosalization varies in association with sex of the subject and type and site of flaps. DNA methyltransferase 1 might correlate with mucosalization, suggesting that DNA methylation may be involved in chronic inflammation in mucosalization.

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Funding

This project was supported by the National Nature Science Foundation of China (No. 81360403) to Feixin Liang. This project was supported by Medical and Health Technology Development and Promotion Application Project of Guangxi (No. S2018067) to Feixin Liang.

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Author notes

  1. Xueru Chen and Yixing Li contributed equally to this work.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China

    Xueru Chen, Yixing Li, Zhuoqian Zhou, Tao Yu, Wan Fan, Chuangui Zeng, Qinchao Tang & Feixin Liang

  2. Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Affiliated Stomatological Hospital, Guangxi Medical University, Nanning, Guangxi, China

    Xueru Chen, Yixing Li, Zhuoqian Zhou, Tao Yu, Wan Fan, Chuangui Zeng, Qinchao Tang & Feixin Liang

  3. Guangxi Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Affiliated Stomatological Hospital, Guangxi Medical University, Nanning, Guangxi, China

    Xueru Chen, Yixing Li, Zhuoqian Zhou, Tao Yu, Wan Fan, Chuangui Zeng, Qinchao Tang & Feixin Liang

  4. Guangxi Clinical Research Center for Craniofacial Deformity, Affiliated Stomatological Hospital, Guangxi Medical University, Nanning, Guangxi, China

    Xueru Chen, Yixing Li, Zhuoqian Zhou, Tao Yu, Wan Fan, Chuangui Zeng, Qinchao Tang & Feixin Liang

Authors
  1. Xueru Chen
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  2. Yixing Li
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  3. Zhuoqian Zhou
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  8. Feixin Liang
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Correspondence to Feixin Liang.

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The research was approved by the Ethics Committee of Guangxi Medical University. Informed consent was provided by all patients.

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Chen, X., Li, Y., Zhou, Z. et al. Clinical and Histological Features of Intraoral Flap and a Preliminary Study of DNA Methylation of Mucosalization. Indian J Surg 82, 559–565 (2020). https://doi.org/10.1007/s12262-019-02029-5

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  • DOI: https://doi.org/10.1007/s12262-019-02029-5

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