Changes in the differentiation pattern of oral mucosal epithelium following heterotopic connective tissue transplantation in man.

Anterior palatal connective tissue was transplanted into wound beds created within the alveolar mucosa of the lower anterior vestibulum in seven adults females. Six months postoperatively, the epithelial lining of the inverted transplants was biopsied and compared histologically, histometrically, and stereologically to the neighboring mucosal epithelium. The data suggest that (1) connective tissue of the lamina propria is primarily responsible for the structural specificity of the overlying epithelium, (2) inductive stimuli are not confined to superficial layers but also originate from deep portions of the lamina propria, (3) these stimuli influence both the epithelial differentiation and the type of epithelium-connective tissue interface, and (4) the epithelial response to the inductive stimuli in man may depend on the individual type of epithelial differentiation pattern originally prevailing at the recipient site. The transplant-lining epithelium assumed features resembling that of the hard palate in subjects with an alveolar mucosal epithelium with cheek-type characteristics. In subjects with an alveolar epithelium displaying a mixed differentiation pattern, the transplant-lining epithelium continued to generate a mixed pattern or else shifted to more palate-like characteristics.