Early Healing of Oral Soft Tissues: a Clinical and Biomolecular Analysis. Part I
Condition: Wound Surgical; Wound Heal; Oral Soft Tissue Conditions
MeSH terms: Wounds and Injuries; Surgical Wound
Study type: Interventional

Summary: 
      The purpose of the present study is to observe and compare -through a biomolecular analysis-
      the differences in the gene expression and cellular behavior in the early wound healing
      process -24 hours after injury- between the following three oral tissues: alveolar mucosa,
      buccal gingiva and palatal tissue.

      The main hypothesis is that there is a difference in the gene expression and in the cellular
      behaviour between the three oral tissues studied and this difference can be observed at 24
      hours post-injury.
    

Detailed description: 
      The wound healing is an extremely complex process. It has been observed that oral wounds
      mechanisms present special features. In fact, mucosal wounds demonstrated accelerated healing
      compared to cutaneous wounds.

      Numerous comparative studies have described important differences of cellular behavior and
      genes expression between oral mucosal and dermal tissues. Moreover, it has been observed that
      the behavior of the cells is autonomous, i.e., that greatest differences seen in the genomic
      response after injury in skin and mucosa are derived, in part, from intrinsic differences in
      the genetic regulation of the cells at each site. Also, it is important to highlight the fact
      that it has been observed that the cellular response after wound is early, showing the first
      and greatest changes at 12-24 hours post injury. Moreover, a recent study has been raised the
      possibility of that the transcriptional regulatory networks responsible for the accelerated
      healing in oral mucosa are already present in the unwounded state.

      In the oral mucosal tissues, the mechanisms underlying scar-less wound healing have been
      studied. Most studies have focused on the cellular characteristics and the molecular
      expression as growing factors, inflammatory mediators, etc., and have evaluated the process
      in later periods.

      Therefore, while the biomolecular basis of the differences in oral mucosal and dermal tissues
      wound healing have been described, this is less well understood in the different oral soft
      tissue wounds.

      The following points must be considered:

        -  The differences in the wound healing between mucosal and dermal tissues have been
           extensively studied through biomolecular analysis.

        -  The behavior of the cells is autonomous.

        -  The changes in the wound healing have been observed after 12-24 hours post-injury.

        -  The transcriptional regulatory networks responsible for the accelerated healing in oral
           mucosa could already be present in the unwounded state.

        -  The differences in the wound healing between the different oral soft tissues (alveolar
           mucosa, buccal gingiva and palatal tissue) has not been studied from a biomolecular
           point of view; however, differences in the clinical behavior and response between these
           three oral tissues has been reported.

      The main questions are:

        1. Twenty-four hours after injury: Are there differences in the gene expression and
           cellular behaviour between the three studied tissues?

        2. The transcriptional regulatory networks responsible for the accelerated oral tissues
           healing:

             -  Are presents in the unwounded state?

             -  Are differences between the three studied oral tissues?

      Deepen the knowledge in the early wound healing process of these tissues and the difference
      between them -evaluating the genes expression and the behavior of the cells- could allow the
      generation of new approaches to improve the healing of oral wounds.
    

Intervention name(s): Oral soft tissues biopsies
Intervention type(s): Other
Intervention description(s): Oral soft tissues biopsies (alveolar mucosa, buccal gingiva, and palatal tissue) will be harvested by the examiner at the time of the surgery (immediately before to start the surgical procedure -T0) and 24 hours after surgery (T24) at the level of the vertical released incisions (VRIs) with a biopsy punch with plunger of 2.0 mm diameter.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: real-time polymerase chain reaction; early wound healing; gingiva; oral mucosa