To better understand the challenges for building full-thickness engineered oral mucosa it is important to first understand the structure of normal oral mucosa. Normal oral mucosa consists of two layers, the top stratified squamous epithelial layer and the bottom lamina propria. The epithelial layer consists of four layers:
* Stratum basale (basal layer)
* Stratum spinosum (spinous layer)
* Stratum granulosum (granular layer)
* Stratum corneum (keratinized/superficial layer)
Depending on the region of the mouth the epithelium may be keratinized or non-keratinized. Non-keratinized squamous epithelium covers the soft palate, lips, cheeks and the floor of the mouth. Keratinized squamous epithelium is present in the gingiva and hard palate. Keratinization is the differentiation of keratinocytes in the granular layer into dead surface cells to form the stratum corneum. The cells terminally differentiate as they migrate to the surface (from the basal layer where the progenitor cells are located to the dead superficial surface).
The lamina propria is a fibrous connective tissue layer that consists of a network of type I and III collagen and elastin fibers. The main cells of the lamina propria are the fibroblasts, which are responsible for the production of the extracellular matrix. The basement membrane forms the border between the epithelial layer and the lamina propria.