Deepithelialized Connective Tissue Graft and the Remaining Epithelial Content After Harvesting by the Harris Technique: A Histological and Morphometrical Case Series

Introduction: The remaining epithelial layer existent in connective tissue graft (CTG) harvested from the hard palate, which underwent de-epithelization outside the oral cavity, can be histologically detected unless it is completely removed. Its presence may cause adverse esthetics results, affecting thus the color and texture of the receptor site, and an increased risk of presence of scar tissues after surgical procedures. The proposal of this study was to evaluate the CTG (histological and morphometrically) collected from the hard palate using the Harris technique, removing the epithelial layer outside the mouth, assessing the remaining presence of epithelial tissue.

Case series: Fourteen patients (14 CTGs) were included in the present case series study, therefore there were two dropouts. A small part of the tip of the graft was harvested and fixed in formalin solution for histological processing, staining, and then to be morphometrically analyzed. The epithelial tissue and CTGs were assessed by three calibrated and double-blinded professionals. All information was compiled, and the statistical analysis was performed. CTGs obtained had a width average of 1224.26 μm. There was no presence of any residual of the epithelium in three samples, whereas only one had the epithelium tissue covering the entire connective layer. Furthermore, seven samples (approximately 50%) had the presence of epithelium.

Conclusion: Within the limitation of this study, there was incomplete removal of the epithelial layer after harvesting the CTG using the Harris technique (44.32%), most likely due to its histological persistency, suggesting to be inaccurate the clinical removal.