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Long-Term Outcomes of Zygomaticomaxillary Reconstruction With Autologous Bone Grafts Supported by Pedicled Buccal Fat Pad Flap. J Craniofac Surg 2021; 32:212-214. [PMID: 32796312 DOI: 10.1097/scs.0000000000006842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the effectiveness of the pedicle buccal fat pad flap combined with autogenous bone grafts to reconstruct zygomaticomaxillary defects after tumor resection. MATERIALS AND METHODS A retrospective case series analysis of 11 patients that underwent zygomaticomaxillary reconstruction after tumor resection with autologous bone grafts supported by pedicle buccal fat pad flap as the lining of the maxillary sinus from January 2009 to December 2015 was performed. All the patients underwent computed tomography to measure the aesthetic appearance, bone graft formation, mucosa of the maxillary sinus, and their response to treatment, including complications. RESULTS With a mean follow-up period of 4.7 years, all patients were pleased with the symmetrical contours of zygomaticomaxillary and symptom improvements of the maxillary sinus except for one patient who complained of transient infraorbital numbness. Recurrence, bone infection or necrosis, and other complications were not observed in the follow-up period. CONCLUSION Pedicled buccal fat pad flap promotes wound healing and prevents the exposure of bone grafts to the maxillary sinus. This technique may be a promising treatment option when reconstructing complicated zygomaticomaxillary defects.
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Mannelli G, Arcuri F, Comini L, Valente D, Spinelli G. Buccal Fat Pad: Report of 24 Cases and Literature Review of 1,635 Cases of Oral Defect Reconstruction. ORL J Otorhinolaryngol Relat Spec 2018; 81:24-35. [DOI: 10.1159/000494027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/25/2018] [Indexed: 11/19/2022]
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Comini LV, Spinelli G, Mannelli G. Algorithm for the treatment of oral and peri-oral defects through local flaps. J Craniomaxillofac Surg 2018; 46:2127-2137. [DOI: 10.1016/j.jcms.2018.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/23/2018] [Accepted: 09/19/2018] [Indexed: 02/07/2023] Open
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Abstract
The buccal fat pad (BFP) is a well-established tool in oral and maxillofacial surgery and its use has proved of value for the closure of oroantral communications. Oroantral communication may be a common complication after sequestrectomy in "bisphosphonate-related osteonecrosis of the jaws."The authors report a clinical case of a 70-year-old female patient in bisphosphonate therapy presented with right maxillary sinusitis and oroantral communication after implants insertion.The BFP was used to close the defect. The patient had an uneventful postoperative healing without dehiscence, infection, and necrosis.The authors postulate that the primary closure of the site with BFP may ensure a sufficient blood supply and adequate protection for an effective bone-healing response to occur.
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Kim MK, Han W, Kim SG. The use of the buccal fat pad flap for oral reconstruction. Maxillofac Plast Reconstr Surg 2017; 39:5. [PMID: 28286743 PMCID: PMC5325802 DOI: 10.1186/s40902-017-0105-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 02/01/2017] [Indexed: 11/10/2022] Open
Abstract
Many congenital and acquired defects occur in the maxillofacial area. The buccal fat pad flap (BFP) is a simple and reliable flap for the treatment of many of these defects because of its rich blood supply and location, which is close to the location of various intraoral defects. In this article, we have reviewed BFP and the associated anatomical background, surgical techniques, and clinical applications. The surgical procedure is simple and has shown a high success rate in various clinical applications (approximately 90%), including the closure of oroantral fistula, correction of congenital defect, treatment of jaw bone necrosis, and reconstruction of tumor defects. The control of etiologic factors, size of defect, anatomical location of defect, and general condition of patient could influence the prognosis after grafting. In conclusion, BFP is a reliable flap that can be applied to various clinical situations.
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Affiliation(s)
- Min-Keun Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 Republic of Korea
| | - Wonil Han
- Han Dental Clinic, Guri, Republic of Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 Republic of Korea
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Intra oral reconstruction with buccal fat pad: Recent applications of autologous tissue transplantation as a local flap. JPRAS Open 2016. [DOI: 10.1016/j.jpra.2016.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Kablan F. The use of Buccal fat pad free graft in regenerative treatment of peri-implantitis: A new and predictable technique. Ann Maxillofac Surg 2016; 5:179-84. [PMID: 26981467 PMCID: PMC4772557 DOI: 10.4103/2231-0746.175759] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction: Peri-implantitis is a common condition, but no particular treatment protocol has shown to be definitively effective. Fat tissue in the oral cavity is widely available and easily accessed. The aim of the current study is to present a novel technique in the treatment of peri-implant lesions, utilizing a free fat tissue graft from the buccal fat pad (BFP). Patients and Methods: Free fat graft (FFG) was harvested from the BFP in eight patients and used with bone substitutes to regenerate 22 peri-implant lesions. Mechanical debridement of the implants surface and the granulation tissue were made with curettes or with Er: YAG laser. Clinical parameters such as plaque index, bleeding on probing, pocket depth, gingival recession, and the clinical attachment level were recorded as a baseline during the follow-up period. In addition, radiological evaluation was made preoperative during the follow-up period. Results: The donor site of the free fat graft was healed without cosmetic defect in all patients. Twenty-two peri-implant lesions were followed up for 12 months. Bleeding on probing and the pocket depth were significantly improved, and the clinical attachment level was achieved and maintained during the follow-up period due to the fibrous healing of the free fat graft. Satisfactory esthetic and functional outcomes of the treated implants were achieved and maintained. Conclusions: Free buccal fat graft heals by fibrosis. The fibrotic tissue adheres strongly to the implant surface and with stand the recurrence of the peri-implant lesion and provides stable and predictable outcome.
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Affiliation(s)
- Fares Kablan
- Department of Oral and Maxillofacial Surgery, The Baruch Padeh Medical Center, Tiberias, Israel
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Khiabani K, Keyhan SO, Varedi P, Hemmat S, Razmdideh R, Hoseini E. Buccal fat pad lifting: an alternative open technique for malar augmentation. J Oral Maxillofac Surg 2013; 72:403.e1-15. [PMID: 24438602 DOI: 10.1016/j.joms.2013.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 10/01/2013] [Accepted: 10/01/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the study was to introduce a novel technique for malar augmentation using buccal fat pad pedicle flaps and to evaluate the long-term results and complications of the technique. MATERIALS AND METHODS The investigators designed and conducted a prospective clinical trial. Patients underwent unilateral malar augmentation surgery using buccal fat pad pedicle flaps from June 2011 through June 2012. Patients underwent surgery for esthetic reasons or for trauma with severely comminuted or old zygomaticomaxillary complex fractures that could not be reduced precisely. The primary predictor variable was the buccal fat pad pedicle flap technique. The primary outcome variables included the amount of augmentation and resorption (which was estimated by comparing pre- with postsurgical photographic views), pain, edema, bruising, and nerve and parotid duct injuries. RESULTS Thirteen patients (8 men and 5 women) underwent malar augmentation in the cheekbone area using the buccal fat pad pedicle flap technique. One year after surgery, the average amount of resorption was 0.376 mm. Other major complications, such as prolonged bruising, massive hematoma, intense pain, asymmetry, and parotid duct injury, were not observed. CONCLUSION These results indicate that this new open-access technique should be considered an alternative method for the management of mild to moderate malar depression in patients undergoing esthetic and post-trauma surgery.
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Affiliation(s)
- Kazem Khiabani
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Jundishapour University of Medical Science, Ahvaz, Iran.
| | - Seied Omid Keyhan
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shahid Rahnemoon Hospital, Yazd, Iran
| | - Payam Varedi
- Chief Resident, Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seifollah Hemmat
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Bandar Abbas University of Medical Science, Bandar Abbas, Iran
| | - Roohollah Razmdideh
- Resident, Department of Oral and Maxillofacial Surgery, Jundishapour University of Medical Science, Ahvaz, Iran
| | - Elham Hoseini
- Resident, Department of Oral and Maxillofacial Surgery, Jundishapour University of Medical Science, Ahvaz, Iran
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Application of the buccal fat pad in oral and maxillofacial reconstruction: Review of 35 cases. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2012. [DOI: 10.1016/j.ajoms.2011.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Chakrabarti J, Tekriwal R, Ganguli A, Ghosh S, Mishra PK. Pedicled buccal fat pad flap for intraoral malignant defects: A series of 29 cases. Indian J Plast Surg 2011; 42:36-42. [PMID: 19881018 PMCID: PMC2772293 DOI: 10.4103/0970-0358.53010] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A buccal fat pad (BFP) as a flap for reconstruction of defects in the oral cavity has been described for a variety of benign conditions. We describe the indications, advantages, and complications of the BFP flap and report our clinical experience with the flap for intraoral reconstruction after tumor removal. From 2005 to 2008, we analyzed 29 patients in the age range of 32 to 82 years old who underwent a pedicled BFP flap reconstruction for oral defects after intraoral tumor removal. Postoperative wound healing and complications including any recurrence was followed-up prospectively. Most of the patients had an uneventful immediate postoperative period with signs of buccal fat pad epithelialization by the end of the first week and complete epithelialization at the end of the first month. On continued follow-up, a linear band of fibrous tissue under the epithelialized mucosa replaced the once reconstructed buccal fat pad. Three patients had varying degrees of hemorrhage: one of them had hematoma that healed with severe fibrosis and of the remaining two, one had a partial flap loss and one had a complete flap loss. Judicious use of buccal fat pad reconstruction offers a simple, convenient, and reliable way to reconstruct small to medium defects of the oral cavity with low morbidity, even in older patients who would not be able to tolerate time-consuming flap reconstruction procedures.
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Affiliation(s)
- Jayanta Chakrabarti
- Department of Surgical Oncology, Cancer Centre, Welfare Home & Research Institute, Thakurpukur, Kolkata - 700063, West Bengal, India
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Batra H, Jindal G, Kaur S. Evaluation of different treatment modalities for closure of oro-antral communications and formulation of a rational approach. J Maxillofac Oral Surg 2010; 9:13-8. [PMID: 23139559 DOI: 10.1007/s12663-010-0006-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Accepted: 02/20/2010] [Indexed: 10/19/2022] Open
Abstract
Oro-antral communication is a common occurrence following removal of maxillary premolars and molars because of anatomic proximity of root apices of these teeth and maxillary antrum. Various methods have been described in literature for closure of these communications which vary from simple local methods like buccal advancement flap to complex distal flaps and grafts. Out of these plethora of the treatment modalities available for the treatment of oro antral fistula, the most simple and commonly used ones are either the buccal flap or the buccal pad of fat. In our study we compared the results, advantages and disadvantages of using buccal advancement technique and buccal fat pad individually and also in combination. With this paper, we aim to shed light on the efficacy of buccal pad of fat and the buccal flap, either alone or together, for the closure of OAF of various regions. We also aim to provide a systematic and rational approach for repair of oro-antral communications.
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Affiliation(s)
- Hemant Batra
- Dept. of Oral and Maxillofacial Surgery, BRS Dental College and Hospital, Panchkula, India ; H. No. 1029, Sector 36C, Chandigarh, India
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On lipoma of the buccal fat pad: Report of two cases and review of the literature. J Plast Reconstr Aesthet Surg 2009; 62:28-35. [DOI: 10.1016/j.bjps.2007.11.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2007] [Accepted: 11/15/2007] [Indexed: 11/23/2022]
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Affiliation(s)
- Kevin Arce
- Department of Oral and Maxillofacial Surgery, John Peter Smith Hospital, 1500 S. Main Street, Fort Worth, TX 76104, USA.
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Zhong LP, Chen GF, Fan LJ, Zhao SF. Immediate reconstruction of maxilla with bone grafts supported by pedicled buccal fat pad graft. ACTA ACUST UNITED AC 2004; 97:147-54. [PMID: 14970773 DOI: 10.1016/j.tripleo.2003.09.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To reconstruct immediately the maxilla with bone grafts after partial maxillary resection and solve complications of exposed bone grafts to the maxillary sinus leading to a high rate of bone infection and sequestration. STUDY DESIGN Thirty-eight patients were treated by immediate reconstruction of the maxilla with bone grafts supported by pedicled buccal fat pad (BFP) graft. The facial contour, the bone healing of the bone grafts, and the function of the maxillary sinus were evaluated with the Waters radiograph and speech evaluation. RESULTS The postoperative healing was satisfactory with normal mouth opening and symmetrical contour of the face. The function of the maxillary sinus was restored with satisfactory speech and symmetrical density on radiograph and the healing of the bone grafts was good without complications such as bone resorption and sequestration. CONCLUSIONS Immediate reconstruction of the maxilla with bone grafts supported by pedicled BFP grafts can restore the facial contour and the function of the maxillary sinus for the patients with partial maxillary resection. It provides a good method to reconstruct the maxillary defects and function in the mouth.
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Affiliation(s)
- Lai-Ping Zhong
- Zhejiang Univeristy College of Medicine, Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, Hangzhou, China.
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Dean A, Alamillos F, García-López A, Sánchez J, Peñalba M. The buccal fat pad flap in oral reconstruction. Head Neck 2001; 23:383-8. [PMID: 11295812 DOI: 10.1002/hed.1048] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The aim of this study is to describe the surgical technique, indications, advantages, and possible complications of the buccal fat pad flap and to report our clinical experience with this flap for intraoral reconstruction after tumor removal. METHODS The flap has been used to reconstruct oral defects after tumor resection in 32 patients, who have been retrospectively analyzed. RESULTS Adequate closure of the defect was achieved during surgery in all cases. In one case, there was partial loss of the flap; this was treated conservatively. In five cases there was some retraction in the reconstructed area. CONCLUSIONS Buccal fat pad as a flap offers an adequate reconstructive option to be born in mind when reconstructing small to medium defects in the oral cavity. It is a simple and quick surgical technique with a low incidence of complications.
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Affiliation(s)
- A Dean
- Department of Oral and Maxillofacial Surgery, Reina Sofía University Hospital, C/ José Ma Martorell 4, 2 -2, 14005 Córdoba, Spain.
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Rapidis AD, Alexandridis CA, Eleftheriadis E, Angelopoulos AP. The use of the buccal fat pad for reconstruction of oral defects: review of the literature and report of 15 cases. J Oral Maxillofac Surg 2000; 58:158-63. [PMID: 10670594 DOI: 10.1016/s0278-2391(00)90330-6] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Although the buccal fat pad (BFP) was originally used as an alternative method for the closure of small to medium-sized oroantral and oronasal communications, its use has now been extended to use after excision of oral malignancies. This report describes experience with this technique. PATIENTS AND METHODS The BFP was used as a pedicled graft to reconstruct medium-sized surgical defects of the oral soft and hard tissues in 15 patients suffering from oral malignant tumors. Six of the defects were in the maxilla, 3 in the retromandibular area, and 6 in the cheek and oral commissure. The BFP was left uncovered to epithelialize in 14 patients, and in one it was covered with lyophilized dura. RESULTS The BFP healed without complications within 3 to 4 weeks in 13 patients, whereas in 2 patients with maxillary defects there was partial loss of the graft, requiring the additional use of an obturator in 1 case and a tongue flap in another to prevent oronasal leakage. Harvesting the graft proved to be extremely easy, and care was only necessary to avoid severing the supporting vascular plexus and the thin capsule covering the BFP. CONCLUSIONS The findings support the view that the BFP is a useful, easy, and uncomplicated alternative method for the reconstruction of small to medium-sized surgical defects of the oral hard and soft tissues.
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Affiliation(s)
- A D Rapidis
- Department of Maxillofacial Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens University School of Dentistry.
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Muzaffar AR, Adams WP, Hartog JM, Rohrich RJ, Byrd HS. Maxillary reconstruction: functional and aesthetic considerations. Plast Reconstr Surg 1999; 104:2172-83; quiz 2184. [PMID: 11149786 DOI: 10.1097/00006534-199912000-00035] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Maxillary reconstruction is a challenging endeavor in functional and aesthetic restoration. Given its central location in the midface and its contributions to the key midfacial elements--the orbits, the zygomaticomaxillary complex, the nasal unit, and the stomatognathic complex--the maxilla functions as the keystone of the midface and unifies these elements into a functional and aesthetic unit. Maxillary defects are inherently complex because they generally involve more than one midfacial component. In addition, most maxillary defects are composite in nature, and they often require skin coverage, bony support, and mucosal lining for reconstruction. In the reconstruction of maxillary defects secondary to trauma, ablative tumor surgery, or congenital deformities, the following goals must be met: (1) obliteration of the defect; (2) restoration of essential functions of the midface, such as mastication and speech; (3) provision for adequate structural support to each of the midfacial units; and (4) aesthetic reconstruction of the external features. This review will discuss the pertinent anatomic considerations, the historical approaches to maxillary reconstruction, and the merits of the techniques in use today, with an emphasis on state-of-the-art reconstruction and dental rehabilitation of extensive maxillary defects.
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Affiliation(s)
- A R Muzaffar
- Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas 75235, USA
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20
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el-Hakim IE, el-Fakharany AM. The use of the pedicled buccal fat pad (BFP) and palatal rotating flaps in closure of oroantral communication and palatal defects. J Laryngol Otol 1999; 113:834-8. [PMID: 10664688 DOI: 10.1017/s0022215100145335] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The use of the buccal fat (BFP) and palatal rotating flaps for the closure of oro-antral communication and reconstruction of palatal defects was compared clinically. The BFP proved to be consistently successful in closing oro-antral fistulae and palatal defects resulting from tumour resection, preserving the normal anatomical architecture of the oral mucosa. No denuded area requiring secondary granulation was required as in the case of palatal flaps. In addition, no facial disfigurement was observed on the operated side. BFP is considered a reliable, convenient method for closure of palatal defects and closure of oro-antral communication. It can also be considered as a reliable back-up procedure in the event of failure of other techniques.
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Affiliation(s)
- I E el-Hakim
- Department of Dental Medicine, Bab El-Sheria University Hospital of Al-Azhar University, Cairo, Egypt.
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21
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Laskin DM. Management of Oroantral Fistula and other Sinus-Related Complications. Oral Maxillofac Surg Clin North Am 1999. [DOI: 10.1016/s1042-3699(20)30943-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Martín-Granizo R, Naval L, Costas A, Goizueta C, Rodriguez F, Monje F, Muñoz M, Diaz F. Use of buccal fat pad to repair intraoral defects: review of 30 cases. Br J Oral Maxillofac Surg 1997; 35:81-4. [PMID: 9146863 DOI: 10.1016/s0266-4356(97)90680-x] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The buccal fat pad has been frequently used for the closure of oro-antral and oro-nasal communications. There are a few studies in the literature reporting its use in defects secondary to tumoral resections. In this paper we consider both the anatomical basis and the surgical technique. We also review 30 cases, used for the repair of 15 defects due to tumoral resections, 8 to maxillary cysts, 6 to communications and 1 secondary to a postraumatic defect. It has been successful in 28 of the 29 patients, with a complete epithelization of the flap, even in 4 cases with partial necrosis of the pad. It is an acceptable type of reconstruction, versatile and of a simple surgical technique. However, its use is limited to small or medium defects, being sometimes scarce.
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Affiliation(s)
- R Martín-Granizo
- Department of Oral and Maxillofacial Surgery, University Hospital de la Princesa, Autónoma University of Madrid, Spain
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Ali A, Fardy MJ, Patton DW. Maxillectomy--to reconstruct or obturate? Results of a UK survey of oral and maxillofacial surgeons. Br J Oral Maxillofac Surg 1995; 33:207-10. [PMID: 8736744 DOI: 10.1016/0266-4356(95)90001-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Post-maxillectomy defects may be restored either by surgical reconstruction or by prostheses and there is continuing controversy about the most appropriate method of rehabilitation in any particular case. A questionnaire was designed to assess the current practices of oral and maxillofacial surgeons in the UK after resection of the maxilla for malignant disease. Maxillectomies were carried out by 83% of surgeons; most surgeons do 1-5 cases a year; 38% of surgeons do reconstruct surgically, but only in 10% of cases. Only 65% of surgeons have access to the services of a restorative dentist; this did influence 19% of surgeons' decision about whether to reconstruct surgically or restore by prosthetic means.
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Affiliation(s)
- A Ali
- Morriston Hospital NHS Trust, Swansea, UK
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Hanazawa Y, Itoh K, Mabashi T, Sato K. Closure of oroantral communications using a pedicled buccal fat pad graft. J Oral Maxillofac Surg 1995; 53:771-5; discussion 775-6. [PMID: 7595791 DOI: 10.1016/0278-2391(95)90329-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE This report evaluates the use of a pedicled buccal fat pad graft for closure of oroantral fistulae. MATERIALS AND METHODS Fourteen patients with oroantral communications, ranging from 8 to 20 mm in diameter, were treated by the use of a pedicled buccal fat pad graft. RESULTS The procedure was successful in 13 of 14 patients. Postoperatively, the orally exposed fat gradually was transformed into a granulation-like tissue and epithelization developed within 3 weeks. CONCLUSION It was concluded that the procedure has wide application and a high degree of success.
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Affiliation(s)
- Y Hanazawa
- Department of Oral Surgery, Kawatetsu Chiba-Hospital, Japan
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Abstract
Within the cheek, wedged between masseter and buccinator, is a biconvex pad of fatty tissue, the corpus adiposum buccae, or buccal fat pad (of Bichat). It contributes significantly to the prominence of the cheek of the newborn infant and is sometimes encountered in surgical procedures in the region of the ramus of the mandible or the maxillary tuberosity. This paper reviews the history of the study of the buccal pad of fat, its anatomical location, blood supply, and comparative anatomy. We have also reviewed the pathology of the buccal pad of fat, including traumatic herniation. The fat pad is of interest surgically as it can be used as a free or pedicled graft to close maxillary defects after excision of tumors.
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Affiliation(s)
- P M Tostevin
- United Medical and Dental School, Division of Anatomy and Cell Biology, Guy's Hospital, London, England
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26
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Ferraro NF, August M. Reconstruction Following Resection for Maxillofacial Tumors. Oral Maxillofac Surg Clin North Am 1993. [DOI: 10.1016/s1042-3699(20)30697-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
The use of the buccal fat pad (BFP) as an uncovered pedicled graft to close oral defects is relatively recent. A series of 29 consecutive cases of reconstruction utilizing the BFP is presented, showing excellent results and without added surgical morbidity. Indications include defects after benign or malignant tumour resection, and the combined BFP/temporalis myofascial pedicled flap is reported as an additional option in reconstruction. Histologic findings in healed reconstruction sites indicate fibrous replacement of the fat tissue, and epithelialization of its oral surface. From the results of this series, we conclude that the use of the BFP for the reconstruction of appropriate surgical defects in the mouth is worthy of consideration.
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Affiliation(s)
- N Samman
- Department of Oral and Maxillofacial Surgery, University of Hong Kong
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Arden RL, Burgio DL. Bone autografting of the craniofacial skeleton: clinical and biological considerations. Am J Otolaryngol 1992; 13:328-41. [PMID: 1443388 DOI: 10.1016/0196-0709(92)90073-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- R L Arden
- Department of Otolaryngology, Harper-Grace Hospitals, Wayne State University School of Medicine, Detroit, MI 48201
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Fujimura N, Nagura H, Enomoto S. Grafting of the buccal fat pad into palatal defects. J Craniomaxillofac Surg 1990; 18:219-22. [PMID: 2167326 DOI: 10.1016/s1010-5182(05)80415-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Grafting of the buccal fat pad was performed in combination with lyophilized porcine dermis in six cases of palatal defects. The use of lyophilized porcine dermis not only simplified the surgical procedure but also permitted a proper prosthetic rehabilitation. This technique proved to have more advantages for palatal defects.
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Affiliation(s)
- N Fujimura
- Dept. of Oral and Maxillofacial Surgery, Tokyo Medical and Dental University, Japan
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