UBC Theses and Dissertations
A clinical study of scar formation in the human palatal mucosa Joslin, Breanne Elizabeth
Scar formation is a frequent consequence of wound healing and has widespread negative effects on individuals’ quality of life, both physically and psychologically. For most people, scars are unsightly, but in addition to this, they can result in serious morbidities such as pruritus, pain, contracture, and decreased heat tolerance in severe situations. The association between degree of scarring and depth of dermal injury has been recognized by surgeons for many years, however the cellular and molecular basis for these observations remains poorly understood. Interestingly, oral wounds have been shown to heal faster and with less clinical and histological scar formation than similar skin wounds. It was hypothesized that palatal wounds in general show relatively little scarring and also that there is increased scar formation of the palatal mucosa following a connective tissue graft (CTG) harvest (deep wound) than a free gingival graft (FGG) harvest (superficial wound). This was a retrospective clinical study carried out at the University of British Columbia, Faculty of Dentistry. Intraoral photographs were taken of the palate in 37 subjects. Each subject had undergone a CTG and/or FGG harvest by a Graduate Periodontics resident more than six months prior to the study. 23 FGG and 23 CTG scars were assessed. Two independent calibrated blinded examiners assessed the photographs using a modified version of the Manchester Scar Proforma. A value of zero, one, or two was given for each parameter, with no difference from normal tissue scored as zero and gross mismatch scored as two. The values for each parameter were summed to produce a total scar score, zero to six, for each site. The component parameters were also examined individually so that color, contour, and distortion could be evaluated independently. The results of this study demonstrated that scar formation in the palatal mucosa is minimal and in many cases, non-existent. CTG donor sites did not have more severe scar formation than FGG sites.
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