Prevention of buccal mucosa scarring with transforming growth factor β3

Objectives/Hypothesis: In the treatment of tumorous diseases, scarring often forms after resection or irradiation. Scarring of the buccal mucosa causes difficulty in opening the mouth and mastication, decreasing quality of life. Transforming growth factor (TGF) β3 is an isoform of TGFβ1 that is known to accelerate scarring, although it has different effects on wound healing. TGFβ3 administration into wounds has been associated with improvement in the quality of healing skin in vivo. TGFβ3 is also considered to be an important anti-scarring factor in buccal mucosa. The present study aimed to examine whether TGFβ3 is effective for prevention and treatment of buccal mucosa scarring. Study Design: Prospective study using an animal model. Methods: Thirty Sprague-Dawley rats were involved in this study. We injected 0.5 mL of TGFβ3 (0.005 μg/mL, 0.05 μg/mL, 0.5 μg/mL, 5 μg/mL) or saline was injected into the buccal submucosa. Fifteen minutes after the injection, the mucosa was removed down to the masseter muscle or orbicularis oris muscle layer using a 6-mm biopsy punch. Six weeks after the operation, the buccal mucosae were harvested after euthanasia. Morphologic and histologic examinations were performed. Results: The administration of 0.5 μg/mL TGFβ3 induced rapid re-epithelialization and suppressed scar formation. In the submucosal layer, favorable restoration of hyaluronic acid and elastin was seen in the TGFβ3-treated groups compared to the saline-treated group. Conclusions: TGFβ3 is considered to be effective for better restoration of extracellular matrices of injured buccal mucosa, suggesting a preventative effect of buccal mucosa scarring.