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The presence of epithelial remnants in CTG has been associated with complications after soft tissue augmentation surgery. However, a specific method for de\u2010epithelization that is patently superior has not been identified yet. This study aimed to evaluate the effectiveness of two different approaches to de\u2010epithelialize CTG samples harvested from the posterior palate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients in need of periodontal or implant\u2010related surgery that required harvesting a CTG from the posterior palate region were recruited. CTG samples harvested with an indirect approach were de\u2010epithelialized using either an intraoral (IO group) or an extraoral (EO group) method. Tissue specimens were subsequently processed for histological analysis. The presence or absence of oral epithelial remnants was determined by two examiners using light microscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010four patients, who provided a total of 46 analyzable CTG samples, were enrolled in this study. Histological assessment revealed that 19 out of 22 samples in the IO group were free of epithelial remnants. In the EO group, 20 out of 24 samples did not exhibit epithelial residues. These results translate into 86.4% and 83.3% of epithelium\u2010free samples in the IO and EO groups, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although the intraoral method may provide several practical advantages compared with the extraoral technique, both approaches for de\u2010epithelialization of CTG samples harvested from the posterior palate region tested in this study were comparably effective. However, none of these methods ensured complete removal of the oral epithelium in a predictable manner, which should be considered in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jper.22-0493","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:39:20Z","timestamp":1672360760000},"page":"652-660","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Comparative histological evaluation of intra\u2010 and extraorally de\u2010epithelialized connective tissue graft samples harvested from the posterior palate region"],"prefix":"10.1002","volume":"94","author":[{"given":"Emilio","family":"Couso\u2010Queiruga","sequence":"first","affiliation":[{"name":"Department of Oral Surgery and Stomatology University of Bern School of Dental Medicine  Bern Switzerland"},{"name":"Formerly, Department of Periodontics University of Iowa College of Dentistry  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3957-4872","authenticated-orcid":false,"given":"Oscar","family":"Gonzalez\u2010Martin","sequence":"additional","affiliation":[{"name":"Private Practice Atelier Dental Madrid  Madrid Spain"},{"name":"Harvard School of Dental Medicine  Boston Massachusetts USA"},{"name":"Department of Periodontology Complutense University of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3473-2149","authenticated-orcid":false,"given":"Sandra","family":"Stuhr","sequence":"additional","affiliation":[{"name":"Formerly, Department of Periodontics University of Iowa College of Dentistry  Iowa City Iowa USA"},{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2160-5829","authenticated-orcid":false,"given":"I\u00f1aki","family":"Gamborena","sequence":"additional","affiliation":[{"name":"Private Practice  San Sebastian Spain"},{"name":"Department of Preventive and Restorative Sciences University of Pennsylvania School of Dental Medicine  Philadelphia Pennsylvania USA"},{"name":"Department of Restorative Dentistry University of Washington School of Dentistry  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-1015","authenticated-orcid":false,"given":"Leandro","family":"Chambrone","sequence":"additional","affiliation":[{"name":"Evidence\u2010Based Hub Interdisciplinary Research Center Egas Moniz (CiiEM) Egas Moniz\u2010Cooperative of Higher Education CRL  Monte de Caparica Portugal"},{"name":"Unit of Basic Oral Investigations (UIBO) School of Dentistry Universidad El Bosque  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5763-0201","authenticated-orcid":false,"given":"Gustavo","family":"Avila\u2010Ortiz","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery and Stomatology University of Bern School of Dental Medicine  Bern Switzerland"},{"name":"Formerly, Department of Periodontics University of Iowa College of Dentistry  Iowa City Iowa USA"},{"name":"Private Practice Atelier Dental Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0715"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.22-0167"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2008.05.007"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0716"},{"key":"e_1_2_9_6_1","volume-title":"TISSUES: Critical Issues in Periodontal and Implant\u2010Related Plastic and Reconstructive Surgery","author":"Chambrone L","year":"2022"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12185"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.1929"},{"key":"e_1_2_9_9_1","first-page":"440","volume-title":"Evolution: Contemporary Protocols for Anterior Single\u2010Tooth Implants","author":"Gamborena I","year":"2014"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-018-2516-9"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2018.10.002"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1974.tb01257.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1985.56.12.715"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1992.63.5.477"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.10124"},{"key":"e_1_2_9_16_1","first-page":"22","article-title":"The subepithelial connective tissue graft. 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