Fresh Frozen Amniotic Membrane and Buccal Pad of Fat for Reconstruction of Oral Mucosal Defect After Surgical Excision of Leukoplakia.

Mostafa Md. Anisuzzaman, Mohammad Khursheed Alam, Safiquer Rahman Khan, Anser Uddin Ahmed


Objective:To compare the use of Fresh Frozen Amniotic Membrane (FFAM) and Buccal Pad of Fat (BPF) for reconstruction of oral mucosal defect after surgical excision of leukoplakia. Material and Methods:Twenty patients were randomly selected and divided into two groups. Group 1 use amniotic membrane graft and Group 2 BPF. Both groups were evaluated preoperatively and postoperatively. Incisal opening, epithelialization and fibrosis were evaluated after one month of surgery. Chi square and Student t tests were used. Results:According to the presence of smoking habits, the highest frequencies were for smoking (30%) and betel leaf areca nut with tobacco (30%). Regarding the diameter of oral leukoplakia, in 40% of the participants it was 2x3 cm2. In Group1, after one month of surgery preoperative and postoperative inter-incisal opening values were 44.20 ± 3.37 and 42.05 ± 3.47 (p<0.001). In Group 2, preoperative and postoperative inter-incisal opening values were 44.09 ± 3.32 and 43.01±3.38 (p>0.05). When FFAM was used complete epithelialization in 70% and incomplete epithelialization in 30% patients. When BPF was used the results were almost similar. Fibrosis occurred in 30% in Group 1. There were no complications like flap necrosis, infectiona and hematoma formation. Conclusion:Incisal opening was significantly better in Fresh Frozen Amniotic MembraneGroup, epithelialization and fibrosis were almost same in both groups after surgical excision of oral leukoplakia.


Extraembryonic Membranes; Amnion; Leukoplakia, Oral; Mouth Neoplasms.

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Kramer IR, Lucas RB, Pindborg JJ, Sobin LH. Definition of leukoplakia and related lesions: An aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol 1978; 46(4):518-39.

Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med 2007; 36(10):575-80.

Van der Waal l, Schepman KP, Van der Mejj EH, Smeele LE. Oral leukoplakia: A clinicopathological review. Oral Oncol 1997; 33(5):291-301.

Boy SC. Leukoplakia and erythroplakia of the oral mucosa: A brief overview. SADJ 2012; 67(10):558-60.

Warnakulasuriya S, Reibel J, Bouquot J, Dabelsteen E. Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement. J Oral Pathol Med 2008; 37(3):127-33.

Silverman S Jr, Gorsky M, Kaugars GE. Leukoplakia, dysplasia, and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 82(2):117.

Davis JW. Skin transplantation with a review of 550 cases at the Johns Hopkins Hospital. Johns Hopkins Med J 1910; 15:307-96.

Stern M. The grafting of preserved amniotic membrane to burned and ulcerated surfaces, substituting skin Grafts - A preliminary report. JAMA 1913; 60(13):973-4.

Talmi YP, Finkelstein Y, Zohar Y. Use of human amniotic membrane as a biological dressing. Eur J Plast Surg 1990; 13(4):160-2.

Adly OA, Moghazy AM, Abbas AH, Ellabban AM, Ali OS, Mohamed BA. Assessment of amniotic and polyurethane membrane dressings in the treatment of burns. Burns 2010; 36(5):703-10.

Andonovska D, Dzokic G, Spasevska L, Trajkovska T, Popovska K, Todorov I, et al. The advantages of the application of amnion membrane in the treatment of burns. Prilozi 2008; 29(1):183-98.

Iijima K, Igawa Y, Imamura T, Moriizumi T, Nikaido T, Konishi I, et al. Transplantation of preserved human amniotic membrane for bladder augmentation in rats. Tissue Eng 2007; 13(3):513-24.

Sarwar I, Sultana R, Nisa RU, Qayyum I. Vaginoplasty by using amnion graft in patients of vaginal agenesis associated with Mayor-Rokitansky-Kuster-Hauser syndrome. J Ayub Med Coll Abbottabad 2010; 22(1):7-10.

Arora M, Jaroudi KA, Hamilton CJ, Dayel F. Controlled comparison of intercede and amniotic membrane graft in the prevention of postoperative adhesions in the rabbit uterine horn model. Eur J Obstet Gynecol Reprod Biol 1994; 55:179-82.

Samandri MH, Yaghmaei M, Ejlali M, Moshref M, Saffar AS. Use of amnion as a graft material in vestibuloplasty: A preliminary report. Oral Surg Oral Med Oral Path Oral Radiol Endod 2004; 97(5):574-8.

Tseng SCG, Prabhasawat P, Lee SH. Amniotic membrane transplantation for conjunctival surface reconstruction. Am J Ophthalmol 1997; 124(6):765-74.

Watkinson JC, Gaze MN, Wilson JA. Tumors of Lip and Oral Cavity. in: Watkinson JC, Gilbert RW. Stell & Maran's Textbook of Head and Neck Surgery and Oncology. 4th. ed. London: CRC Press, 2000. Chapter 15. pp. 275-318.

Sharma R, Thapliyal GK, Sinha R, Menon PS. Use of buccal fat pad for treatment of oral submucous fibrosis. J Oral Maxillofac Surg 2012; 70(1):228-32.

Dua HS, Azuara-Blanco A. Amniotic membrane transplantation. Br J Ophthalmol 1999; 83(6):748-52.