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Pimentel KF, de Lima Sousa MG, Dos Santos Passos A, Farias RJ, Guerra JM, Costa FWG, Sousa FB, Silva PGB, Cetira Filho EL. The impact of partially removing the Bichat fat pad in the linear facial measurements, satisfaction with facial aesthetics and quality of life: a single-arm CONSORT-guided clinical trial. Clin Oral Investig 2023; 27:249-262. [PMID: 36152084 DOI: 10.1007/s00784-022-04718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 09/07/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate the influence of Bichat's ball removal on postoperative inflammatory parameters (pain, edema, and trismus), facial volume reduction, facial esthetic satisfaction, and oral health-related quality of life. MATERIAL AND METHODS A single-arm clinical trial with 21 patients undergoing Bichat's ball removal. The following parameters were assessed at baseline and up to 3 months postoperatively: Visual Analogue Scale pain scores (0-10), rescue medication consumption, mouth opening, AM-Tr, AM-CEO, AM-NA, AM-CL, and AM-PM measurements, Oral Health Impact Profile (OHIP)-14 QoL scores, and satisfaction with facial esthetics (FACE-Q Satisfaction with Facial Appearance Overall Scale (SFAOS). X2, analysis of variance-repeated measures/Bonferroni, or Friedman/Dunn tests were used (p < 0.05, SPSS v20.0). RESULTS Peak pain occurred after 2 h and, 10 h later, the levels returned to baseline values (p < 0.001). Rescue medication consumption peaked in the first 24 h reducing significantly after 72 h (p < 0.001). Mean mouth opening decreased after 24 h and returned to baseline levels after 1 month, and all linear facial measures reduced significantly after 1 or 3 months (p < 0.05). OHIP-14 scores and FACE-Q SFAOS scores showed significant improvement after 1 month (p < 0.001), but patients aged > 25 years showed a significant reduction in FACE-Q SFAOS at the end of the study (p = 0.006). CONCLUSIONS Surgical removal of the Bichat's ball induces a mild inflammatory process controlled by rescue medication, significantly reduces face volume, and improves QoL and satisfaction with facial esthetics 3 months postoperatively. However, the efficacy of this procedure in patients > 25 years old is questionable. CLINICAL RELEVANCE Evaluate the effectiveness of bichectomy in terms of clinical effects and impact on quality of life.
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Affiliation(s)
- Kamila França Pimentel
- Department of Dentistry, Unichristus, João Adolfo Gurgel Street, 133, Cocó, Ceará, Fortaleza, Brazil
| | | | | | - Ravy Jucá Farias
- Department of Dentistry, Unichristus, João Adolfo Gurgel Street, 133, Cocó, Ceará, Fortaleza, Brazil
| | - Janaina Motta Guerra
- Department of Dentistry, Unichristus, João Adolfo Gurgel Street, 133, Cocó, Ceará, Fortaleza, Brazil
| | | | - Fabrício Bitu Sousa
- Department of Dentistry, Unichristus, João Adolfo Gurgel Street, 133, Cocó, Ceará, Fortaleza, Brazil
| | | | - Edson Luiz Cetira Filho
- Division of Oral and Maxillofacial Surgery, Postgraduate Program in Dentistry, Federal University of Ceará, Ceará, Fortaleza, Brazil.,Unichristus, Ceará, Fortaleza, Brazil
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Consorti G, Catarzi L, Messi M, Valassina D, Balercia P. New Tunneled Buccal Fat Pad Flap for Palatal Reconstruction. Craniomaxillofac Trauma Reconstr 2022; 15:90-94. [PMID: 35265283 PMCID: PMC8899347 DOI: 10.1177/1943387520988433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the palatal defects due to surgical resection, flap selection is very important for a correct reconstruction. Different methods have been suggested over the time, however the pedicled buccal fat pad is a simple, effective, reliable flap for reconstruction after palate tumor resection. The aim of the present study is to introduce a new surgical technique for palate reconstruction with pedicled buccal fat pad flap exposing the advantages. The Authors performed this procedure in 17 patients in order to treat medium-sized oncologic surgical defect of palate region in the period between 2016 and 2019. Complete wound healing after only 4 weeks without complication after 12 months follow-up was observed. This is the first cases series described with this new technique.
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Affiliation(s)
- Giuseppe Consorti
- Maxillo-Facial Surgery Unit, Azienda Ospedaliera Universitaria “Ospedali Riuniti di Ancona,” Umberto I, Ancona, Italy,Giuseppe Consorti, MD, Maxillo-Facial Surgery Unit, Azienda Ospedaliera Universitaria “Ospedali Riuniti di Ancona,” Umberto I, via Conca 71, Ancona 60126, Italy.
| | - Lisa Catarzi
- Maxillo-Facial Surgery, University of Siena, Siena, Italy
| | - Marco Messi
- Maxillo-Facial Surgery Unit, Azienda Ospedaliera Universitaria “Ospedali Riuniti di Ancona,” Umberto I, Ancona, Italy
| | - Davide Valassina
- Maxillo-Facial Surgery Unit, Azienda Ospedaliera Universitaria “Ospedali Riuniti di Ancona,” Umberto I, Ancona, Italy
| | - Paolo Balercia
- Maxillo-Facial Surgery Unit, Azienda Ospedaliera Universitaria “Ospedali Riuniti di Ancona,” Umberto I, Ancona, Italy
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Consorti G, Catarzi L, Valassina D, Balercia P. Palatal reconstruction with tunnellized Bichat fat pad flap after tumour resection. Minerva Dent Oral Sci 2021; 71:168-173. [PMID: 33929131 DOI: 10.23736/s2724-6329.21.04459-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Reconstruction of palate defects following tumour ablative surgery can be a challenging problem. Different methods have been suggested over the time for the reconstruction of postoperative palatal defects. Since the first report of the Bichat fat pad flap in1977, it has become one of the most commonly used flaps for the reconstruction of palate after tumour excision. We report our results using the tunnellized Bichat fat pad (BFP) flap for 23 cases of palate reconstruction after minor salivary glands tumour excision. METHODS The Authors performed a tunnellized bichat fat pad flap for primary reconstruction of small- medium-sized surgical defects of the palate in 23 patients suffering from minor salivary glands palatal tumors in the period between 2016 and 2019. Each case was reviewed for primary pathologic findings, wound healing, postoperative complications. RESULTS All 23 tunnellized BFP procedures showed excellent recovery and uneventful follow-up. With this technique after 12 months follow-up complete wound healing after only 4 weeks without complication was observed. CONCLUSIONS The tunnellized BFP flap is useful, easy, and uncomplicated new alternative method for primary reconstruction of small to medium-sized palatal surgical defects, that can be performed with a very low morbidity. Submucosal tunnel for the pedicle passage introduced by the Authors adds some advantages in final outcomes with less discomfort for the patients, proving to be a technique able to adds itself to surgical reconstructive technique available today.
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Affiliation(s)
- Giuseppe Consorti
- Department of Maxillo-Facial Surgery, Azienda Universitaria Ospedaliera Ospedali Riuniti Umberto I, Ancona, Italy -
| | - Lisa Catarzi
- Maxillo-Facial Surgery Residency, Azienda Ospedaliera Universitaria Senese, Università degli Studi di Siena, Siena, Italy
| | - Davide Valassina
- Department of Maxillo-Facial Surgery, Azienda Universitaria Ospedaliera Ospedali Riuniti Umberto I, Ancona, Italy
| | - Paolo Balercia
- Department of Maxillo-Facial Surgery, Azienda Universitaria Ospedaliera Ospedali Riuniti Umberto I, Ancona, Italy
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4
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Rikhotso RE. Use of buccal fat pad as a pedicled graft for maxillary reconstruction in a 6-months old with juvenile aggressive ossifying fibroma. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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5
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Park J, Chun BD, Kim UK, Choi NR, Choi HS, Hwang DS. Versatility of the pedicled buccal fat pad flap for the management of oroantral fistula: a retrospective study of 25 cases. Maxillofac Plast Reconstr Surg 2019; 41:50. [PMID: 31824888 PMCID: PMC6877680 DOI: 10.1186/s40902-019-0229-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/23/2019] [Indexed: 12/01/2022] Open
Abstract
Purpose Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. Materials and methods We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. Results A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19:6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. Conclusions The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.
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Affiliation(s)
- Jinyoung Park
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.,Dental Research Institute, Pusan National Dental Hospital, Yangsan, Republic of Korea
| | - Byung-do Chun
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Uk-Kyu Kim
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.,Dental Research Institute, Pusan National Dental Hospital, Yangsan, Republic of Korea
| | - Na-Rae Choi
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.,Dental Research Institute, Pusan National Dental Hospital, Yangsan, Republic of Korea
| | - Hong-Seok Choi
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.,Dental Research Institute, Pusan National Dental Hospital, Yangsan, Republic of Korea
| | - Dae-Seok Hwang
- 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.,2Dental and Life Sciences Institute, Pusan National University, Yangsan, Republic of Korea.,Dental Research Institute, Pusan National Dental Hospital, Yangsan, Republic of Korea
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6
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Buccal Fat Pad a Forgotten Option of Reconstruction in Oral Cancer. Indian J Otolaryngol Head Neck Surg 2019; 71:248-252. [PMID: 31741968 DOI: 10.1007/s12070-018-1257-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 01/30/2018] [Indexed: 10/18/2022] Open
Abstract
The buccal fat pad (BFP) originally described as an anatomic structure without any obvious function. For long period it was considered to be surgical nuisance. However during the last four decades buccal fat is successively used tool for maxillofacial surgery for reconstruction of small to medium sized acquired or congenital soft tissue and bony defect in oral cavity. The aim of present article is to review the database available regarding BFP including its anatomy, clinical usage in oral malignancy as tool of reconstruction after ablative procedures it's success and its adoptability with other loco-regional flap for oral reconstruction in different scenario and our experience with it in tertiary cancer centre in India.
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Lesions of the Parotid Gland and Buccal Artery After Buccal Fat Pad Reduction. J Craniofac Surg 2019; 30:790-792. [DOI: 10.1097/scs.0000000000004880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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8
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Olsson AB, Dillon J, Kolokythas A, Schlott BJ. Reconstructive Surgery. J Oral Maxillofac Surg 2019; 75:e264-e301. [PMID: 28728733 DOI: 10.1016/j.joms.2017.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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9
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Khojasteh A, Hosseinpour S, Rezai Rad M, Alikhasi M, Zadeh HH. Buccal fat pad-derived stem cells with anorganic bovine bone mineral scaffold for augmentation of atrophic posterior mandible: An exploratory prospective clinical study. Clin Implant Dent Relat Res 2019; 21:292-300. [PMID: 30821120 DOI: 10.1111/cid.12729] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/19/2018] [Accepted: 12/18/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Application of adipose-derived stem cells originated from buccal fat pad (BFP) can simplify surgical procedures and diminish clinical risks compared to large autograft harvesting. PURPOSE This study sought to evaluate and compare the efficacy of buccal fat pad-derived stem cells (BFPSCs) in combination with anorganic bovine bone mineral (ABBM) for vertical and horizontal augmentation of atrophic posterior mandibles. MATERIALS AND METHODS Fourteen patients with atrophic posterior mandible were elected for this prospective exploratory study. BFP (3-5 mL) was harvested and BFPSCs were isolated and combined with ABBM at 50% ratio. The vertical and horizontal alveolar deficiencies were augmented by 50% mixture of ABBM with either BFPSCs (group 1) or particulated autologous bone (group 2). Titanium mesh was contoured to the desired 3D shape of the alveolar ridge and fixated to the host sites over the graft material of the two groups. At first, the amount of new bone areas was calculated by quantitative analysis of cone beam computed tomography (CBCT) images that were taken 6 months postoperatively according to regenerative techniques (group 1 vs group 2 without considering the type of bone defects). Second, these amounts were calculated in each group based on the type of defects. RESULTS Quantitative analysis of CBCT images revealed the areas of new bone formation were 169.5 ± 5.90 mm2 and 166.75 ± 10.05 mm2 in groups 1 and 2, respectively. The area of new bone formation for vertical defects were 164.91 ± 3.74 mm2 and 169.36 ± 12.09 mm2 in groups 1 and 2, respectively. The area of new bone formation for horizontal deficiencies were 170.51 ± 4.54 mm2 and 166.98 ± 9.36 mm2 in groups 1 and 2, respectively. There were no statistically significant differences between the two groups in any of the pair-wise comparisons (P > 0.05). CONCLUSIONS The findings of the present study demonstrated lack of difference in bone volume formation between BFPSCs and autologous particulate bone in combination with ABBM. If confirmed by future large-scale clinical trial, BFPSCs may provide an alternative to autogenous bone for reconstruction of alveolar ridge defects.
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Affiliation(s)
- Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepanta Hosseinpour
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rezai Rad
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Alikhasi
- Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, School of dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun H Zadeh
- Laboratory for Immunoregulation and Tissue Engineering (LITE), Ostrow School of Dentistry of USC, University of Southern California, Los Angeles, California
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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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11
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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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12
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Aljohani S, Troeltzsch M, Hafner S, Kaeppler G, Mast G, Otto S. Surgical treatment of medication-related osteonecrosis of the upper jaw: Case series. Oral Dis 2018; 25:497-507. [PMID: 30325561 DOI: 10.1111/odi.12992] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/21/2018] [Accepted: 10/10/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The management of maxillary medication-related osteonecrosis of the jaw (MRONJ) is challenging. Therefore, identifying the proper treatment is important. This study aimed to evaluate the surgical treatment of maxillary MRONJ using single-layer closure with mucoperiosteal flap and double-layer closure with buccal fat pad flap (BFPF) and mucoperiosteal flap and to find the outcomes after rehabilitation with obturators. METHODS A retrospective analysis was conducted and included all surgically treated and followed-up maxillary MRONJ cases in a single center. Demographics and clinical data, stage of MRONJ, surgical treatment, and treatment outcome were collected. RESULTS Seventy-nine lesions were included. Removal of necrotic bone was followed by coverage with mucoperiosteal flap in 60 lesions and BFPF in 14 lesions. Seven lesions (five primarily and two following unsuccessful treatment with BFPF) underwent necrectomy and were reconstructed with obturators. Complete mucosal healing was achieved in 76.7% of the lesions covered with mucoperiosteal flap. BFPF led to complete mucosal healing in 85.7% of the lesions. No complications were observed in the defects rehabilitated with obturators. CONCLUSION Removal of necrotic bone followed by closure with mucoperiosteal flap is reliable for MRONJ treatment. BFPF is effective for closure of MRONJ-related oroantral communications (OACs).
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Affiliation(s)
- Suad Aljohani
- Department of Oral- and Maxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany.,Department of Oral Basic & Clinical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Matthias Troeltzsch
- Department of Oral- and Maxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Sigurd Hafner
- Department of Oral- and Maxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Gabriele Kaeppler
- Department of Oral and Maxillofacial Radiology, Clinic for Oral and Craniomaxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Gerson Mast
- Department of Oral- and Maxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany
| | - Sven Otto
- Department of Oral- and Maxillofacial Surgery, Ludwig-Maximilians-University, Munich, Germany
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Khojasteh A, Hosseinpour S, Rad MR, Alikhasi M. Buccal Fat Pad-Derived Stem Cells in Three-Dimensional Rehabilitation of Large Alveolar Defects: A Report of Two Cases. J ORAL IMPLANTOL 2018; 45:45-54. [PMID: 30280966 DOI: 10.1563/aaid-joi-d-17-00215] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This case report seeks to describe efficient clinical application of adipose-derived stem cells (AdSCs) originated from buccal fat pad (BFP) in combination with conventional guided bone regeneration as protected healing space for reconstruction of large alveolar defects after extraction of multiple impacted teeth. The first case was a 19-year-old woman with several impacted teeth in the maxillary and mandibular regions, which could not be forced to erupt and were recommended for surgical extraction by the orthodontist. After this procedure, a large bone defect was created, and this space was filled by AdSC loaded natural bovine bone mineral (NBBM), which was protected with lateral ramus cortical plates, microscrews, and collagen membrane. After 6 months of post-guided bone regeneration, the patient received 6 and 7 implant placements, respectively, in the maxilla and mandible. At 10 months postoperatively, radiographic evaluation revealed thorough survival of implants. The second case was a 22-year-old man with the same complaint and large bony defects created after his teeth were extracted. After 6 months of post-guided bone regeneration, he received 4 dental implants in his maxilla and 7 implants in the mandible. At 48 months postoperatively, radiographs showed complete survival of implants. This approach represented a considerable amount of 3-dimensional bone formation in both cases, which enabled us to use dental implant therapy for rehabilitation of the whole dentition. The application of AdSCs isolated from BFP in combination with NBBM can be considered an efficient treatment for bone regeneration in large alveolar bone defects.
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Affiliation(s)
- Arash Khojasteh
- 1 Department of Tissue Engineering and Cell Therapy, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,2 Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Maryam Rezai Rad
- 2 Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Alikhasi
- 4 Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Dos Santos DM, de Caxias FP, Bitencourt SB, Turcio KH, Pesqueira AA, Goiato MC. Oral rehabilitation of patients after maxillectomy. A systematic review. Br J Oral Maxillofac Surg 2018; 56:256-266. [PMID: 29655661 DOI: 10.1016/j.bjoms.2018.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/05/2018] [Indexed: 11/30/2022]
Abstract
Patients who have maxillectomy can be rehabilitated with reconstructive surgery or obturator prostheses with or without osseointegratable implants. To identify studies on possible treatments in this group, we systematically searched the Scopus, Embase, PubMed/Medline, and Cochrane databases to collect data on patients' characteristics, radiotherapy, and results related to speech, swallowing, mastication or diet, chewing, aesthetics, and quality of life. Of the 1376 papers found, six were included, and one other was included after an additional search of references. A total of 252 patients were included, and of them, 86 had reconstructive surgery, 91 were treated with obturator prostheses, 39 had reconstructive surgery or obturator prostheses associated with implants, and 36 had reconstruction plus an obturator prosthesis. Data on radiotherapy were incomplete. There is a lack of consensus about the indication for rehabilitation, as the treatment must be based on the individual characteristics of each patient.
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Affiliation(s)
- D M Dos Santos
- Department of Dental Materials and Prosthodontics and Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - F P de Caxias
- Department of Dental Materials and Prosthodontics and Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - S B Bitencourt
- Department of Dental Materials and Prosthodontics and Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - K H Turcio
- Department of Dental Materials and Prosthodontics and Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - A A Pesqueira
- Department of Dental Materials and Prosthodontics and Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - M C Goiato
- Department of Dental Materials and Prosthodontics and Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
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15
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A worldwide comparison of the management of surgical treatment of advanced oral cancer. J Craniomaxillofac Surg 2018; 46:511-520. [DOI: 10.1016/j.jcms.2017.12.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/15/2017] [Accepted: 12/29/2017] [Indexed: 11/21/2022] Open
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Buccal Fat Pad as a Potential Source of Stem Cells for Bone Regeneration: A Literature Review. Stem Cells Int 2017; 2017:8354640. [PMID: 28757880 PMCID: PMC5516750 DOI: 10.1155/2017/8354640] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 04/17/2017] [Accepted: 05/16/2017] [Indexed: 12/21/2022] Open
Abstract
Adipose tissues hold great promise in bone tissue engineering since they are available in large quantities as a waste material. The buccal fat pad (BFP) is a specialized adipose tissue that is easy to harvest and contains a rich blood supply, and its harvesting causes low complications for patients. This review focuses on the characteristics and osteogenic capability of stem cells derived from BFP as a valuable cell source for bone tissue engineering. An electronic search was performed on all in vitro and in vivo studies that used stem cells from BFP for the purpose of bone tissue engineering from 2010 until 2016. This review was organized according to the PRISMA statement. Adipose-derived stem cells derived from BFP (BFPSCs) were compared with adipose tissues from other parts of the body (AdSCs). Moreover, the osteogenic capability of dedifferentiated fat cells (DFAT) derived from BFP (BFP-DFAT) has been reported in comparison with BFPSCs. BFP is an easily accessible source of stem cells that can be obtained via the oral cavity without injury to the external body surface. Comparing BFPSCs with AdSCs indicated similar cell yield, morphology, and multilineage differentiation. However, BFPSCs proliferate faster and are more prone to producing colonies than AdSCs.
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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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Abstract
PURPOSE Oral soft tissue augmentation or grafting procedures are often necessary to achieve proper wound closure after deficits resulting from tumor excision, clefts, trauma, dental implants, and tooth recessions. MATERIALS AND METHODS Autologous soft tissue grafts still remain the gold standard to acquire a functionally adequate zone of keratinized attached gingiva. However, soft tissue substitutes are more commonly used because they minimize morbidity and shorten surgical time. RESULTS This review aimed to assess soft tissue grafting techniques and materials used in the oral cavity from existing literature. There are a large variety of materials and techniques, including grafts, local flaps, allogenic derived matrices such as acellular dermal allograft, xenogenic tissue matrices from animal origin, and synthetic materials. CONCLUSIONS Tissue engineering of oral mucosa represents an interesting alternative to obtain sufficient autologous tissue for reconstructing oral wounds using biodegradable scaffolds, and may improve vascularization and epithelialization, which are critical for successful outcomes.
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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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Bande C, Dawane P, Gupta MK, Gawande M, Rode V. Immediate versus delayed aggressive physical therapy following buccal fat pad interposition in oral submucous fibrosis-a prospective study in Central India. Oral Maxillofac Surg 2016; 20:397-403. [PMID: 27683297 DOI: 10.1007/s10006-016-0580-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/09/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Oral submucous fibrosis is a disease of an Indian subcontinent with obscure aetiology and poorly treated with varying signs and symptoms. OSMF occurs at any age but is most commonly seen in teenagers and adults in the age ranging between 16 and 35 years. A number of surgical treatments have been used for the treatment of oral submucous fibrosis with unpredictable results. PATIENTS AND METHOD In this study, 220 patients were randomly divided into two groups with mouth opening less than 16 mm and evaluated with immediate and delayed aggressive physiotherapy with buccal fat pad interposition after fibrotomy. Group A (n = 110) patients underwent aggressive mouth opening exercise from the next postoperative day while in group B (n = 110), patients underwent physiotherapy 7th day postoperatively. Pain and discomfort, mucosalization, infection, flap dehiscence and necrosis were noted. Patients were followed for 1 year on a regular interval basis. RESULTS At the end of 1-year follow up, the post-operative mean mouth opening in group A was 38.63 mm and 34.19 mm in group B. In group A, the immediate physiotherapy results in mild to moderate pain and discomfort to the patients as compared to no apparent pain in the group B. The mean mucosalization time in group A and group B was 4.2 and 5.1 weeks, respectively. Postoperatively, all patients achieve satisfactory mouth opening. CONCLUSION Immediate aggressive physiotherapy yields a comparatively superior result than delayed physiotherapy with respect to mouth opening in 1 year of follow-up.
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Affiliation(s)
| | - Pawan Dawane
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
| | - M K Gupta
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
| | - Mayur Gawande
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
| | - Vijay Rode
- Swargiya Dadasaheb Kalmegh Smruti Dental College And Hospital, Nagpur, India
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Habib AMA, Medra A. The Feasibility of Buccal Fat Pad Flap in Oral Reconstruction Based on Clinical Experience in a Governmental Hospital, Alexandria, Egypt. Cleft Palate Craniofac J 2015; 53:657-663. [PMID: 26606163 DOI: 10.1597/15-106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the pedicled buccal fat pad flap for its applicability in the reconstruction of surgically created oral defects. We highlighted the technique of flap harvesting, its different applications, and limitations. DESIGN Prospective analysis of patients with intraoral defects repaired by the buccal fat pad flap. SETTING Institutional center. PATIENTS/PARTICIPANTS Twenty-nine patients with surgical defects of the palate, maxilla, upper gingiva, buccal mucosa, lower gingiva, retromolar region, oral floor, and temporomandibular joint. INTERVENTIONS Pedicled buccal fat pad flap for treatment of small to medium-sized intraoral defects. OUTCOME MEASURES Patients had repair using a pedicled buccal fat pad flap between 2012 and 2014. Patients' photographs and clinical records were collected. The technique of flap harvesting, its advantages, and its drawbacks are described in this study. RESULTS Patients were followed up over a mean period of 13.7 months to check flap viability, competent repair, and donor site function and aesthetics. Complete epithelialization was observed within 4 to 6 weeks postoperatively according to the extent of the defect. All patients showed uneventful healing without complications. CONCLUSIONS Buccal fat pad flap proved to be feasible for the reconstruction of surgically induced proximal small to medium-sized defects and can be extended to the palate, mandible, mouth angle, and temporomandibular joint region. Further research using preoperative computed tomography or magnetic resonance imaging for evaluation of the size of the buccal fat pad is needed when reconstructing large distal defects.
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Osteoradionecrosis of the Posterior Maxilla: A New Approach Combining Erbium: Yttrium Aluminium Garnet Laser and Bichat Bulla Flap. J Craniofac Surg 2015; 26:e627-9. [PMID: 26468848 DOI: 10.1097/scs.0000000000002136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Osteoradionecrosis (ORN) of the jaw is a complication of radiation therapy for head and neck cancers. We report a case of ORN of the posterior maxilla treated with Er: YAG laser and a pedicled buccal fat pad (bichat bulla adipose) flap. A 69-year-old man presented complaining of pain on left maxilla. He had received high-dose radiotherapy (90 Gy) for squamous cell carcinoma of the left soft palate 2 years earlier. Clinical and radiographic examinations revealed ORN of the left maxillary molar region and maxillary sinusitis. Daily home care consisted of 0.9% saline irrigation and 0.8% H2O2 gel application. Sequestrectomy and tooth extraction were followed by debridement with Er: YAG laser and repair with a pedicled buccal fat pad flap. Complete resolution of ORN and maxillary sinusitis was established one year postsurgically. The excellent clinical outcome suggests that Er: YAG laser debridement and pedicled buccal fat pad flap are a viable option to treat ORN of the posterior maxilla.
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Ardeshirylajimi A, Mossahebi-Mohammadi M, Vakilian S, Langroudi L, Seyedjafari E, Atashi A, Soleimani M. Comparison of osteogenic differentiation potential of human adult stem cells loaded on bioceramic-coated electrospun poly (L-lactide) nanofibres. Cell Prolif 2014; 48:47-58. [PMID: 25495212 DOI: 10.1111/cpr.12156] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 08/31/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To compare potential of four types of stem cell in tissue engineering and regenerative medicine applications, osteogenic capacity of newly introduced mesenchymal stem cells (MSCs) derived from buccal fat pads (BFP) (an adipose-encapsulated mass of the oral cavity), was compared to those isolated from bone marrow (BM-MSCs), adipose tissue (AT-MSCs) and unrestricted somatic stem cells (USSCs). Cells were cultured on poly (L-lactide) (PLLA) nanofibres, Bio-Oss(®)-coated PLLA (PLLA-Bio), and culture plates (TCPS) as control. MATERIALS AND METHODS Capacity of proliferation and osteogenic differentiation of the stem cells was investigated by MTT assay and common osteogenic markers, alkaline phosphatase activity, calcium mineral deposition and bone-related genes. RESULTS Highest proliferation level was observed in cells cultured on PLLA-Bio, but with no significant difference between proliferation levels of the four types of stem cell. Over the period of study, BM-MSCs cultured on PLLA-Bio scaffolds exhibited greatest alkaline phosphatase (ALP) activity and mineralization with BFP-MSCs having the next closest results. However, AT-MSC had the lowest capacity for ALP activity and mineralization during osteogenic differentiation. Gene expression evaluation revealed that highest expression of three important bone-related genes was observed in stem cells cultured on bioceramic-coated nanofibrous scaffolds. CONCLUSIONS Results indicated Bio-Oss-coated PLLA to compose most appropriate substrates to support proliferation and osteogenic differentiation of stem cells in vitro. BFP-MSCs demonstrated the same osteogenic differentiation capacity as other stem cells tested and thus hold very promising potential for applications in bone tissue engineering and regenerative medicine.
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Affiliation(s)
- A Ardeshirylajimi
- Department of Stem Cell Biology, Stem Cell Technology Research Center, 1997775555, Tehran, Iran
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Ye W, Song Y, Ying B, Hu J, Zhang C, Zhang Z. Use of the buccal fat pad in the immediate reconstruction of palatal defects related to cancer surgery with postoperative radiation therapy. J Oral Maxillofac Surg 2014; 72:2613-20. [PMID: 25262397 DOI: 10.1016/j.joms.2014.06.459] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 06/30/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the use of the buccal fat pad (BFP) in the immediate reconstruction of oncologic palate defects and the influence of postoperative radiotherapy on reconstruction. PATIENTS AND METHODS Patients who were diagnosed with moderate- to high-grade malignancies of the palate underwent partial maxillectomy. The BFP was used as a pedicled flap to reconstruct the defects. All patients received postoperative radiotherapy 4 to 5 weeks after surgery. RESULTS Eighteen patients (9 men and 9 women; age range, 37 to 81 yr) underwent surgery and subsequent radiotherapy. The size of all defects ranged from 7.5 to 19.2 cm2. Adequate closure of the defects was achieved during surgery and all flaps were epithelialized within 3 weeks after surgery, with no complications of dehiscence or flap failure. Furthermore, there were no complications derived from postoperative radiotherapy. CONCLUSIONS This study suggests that BFP grafting is an effective and reliable method for the reconstruction of small to medium-size palate defects. Furthermore, postoperative radiotherapy does not influence the success of reconstruction.
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Affiliation(s)
- Weimin Ye
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yipeng Song
- Associate Professor, Department of Radiotherapy, Yu-Huang-Ding Hospital affiliated to Tsingtao University, Yantai, China
| | - Binbin Ying
- Associate Professor, Department of Stomatology, Ningbo First Hospital, Ningbo, China
| | - Jingzhou Hu
- Attending Surgeon, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Chenping Zhang
- Professor, Department Head, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhiyuan Zhang
- Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
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Abstract
Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using an obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. This review article discusses the rationale and oncological safety of the reconstructing the maxillary defects, critically analyzes the classification systems, offers the different reconstructive methods and touches upon the controversies in this subject. The management of the retained and exenterated orbit associated with maxillectomy is reviewed. The surgical morbidity, complications and the recent advances in this field are also looked into. An algorithm, based on our experience, is presented.
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Affiliation(s)
- Subramania Iyer
- Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
| | - Krishnakumar Thankappan
- Department of Plastic, Reconstructive and Head and Neck Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India
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A Novel Approach to Immediate Restoration of the Cosmetic Deformity After Regional Temporalis Flap Reconstruction of a Maxillary Defect. J Craniofac Surg 2013; 24:2186-9. [DOI: 10.1097/scs.0b013e3182a41c7f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Toshihiro Y, Nariai Y, Takamura Y, Yoshimura H, Tobita T, Yoshino A, Tatsumi H, Tsunematsu K, Ohba S, Kondo S, Yanai C, Ishibashi H, Sekine J. Applicability of buccal fat pad grafting for oral reconstruction. Int J Oral Maxillofac Surg 2013; 42:604-10. [DOI: 10.1016/j.ijom.2012.07.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 05/21/2012] [Accepted: 07/19/2012] [Indexed: 11/28/2022]
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Broccaioli E, Niada S, Rasperini G, Ferreira LM, Arrigoni E, Yenagi V, Brini AT. Mesenchymal Stem Cells from Bichat's Fat Pad: In Vitro Comparison with Adipose-Derived Stem Cells from Subcutaneous Tissue. Biores Open Access 2013; 2:107-17. [PMID: 23593563 PMCID: PMC3620540 DOI: 10.1089/biores.2012.0291] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Adipose-derived stem/stromal cells (ASCs) are progenitor cells used in bone tissue engineering and regenerative medicine. Since Bichat's fat pad is easily accessible for dentists and maxillo-facial surgeons, we compared the features of ASCs from Bichat's fat pad (BFP-ASCs) with human ASCs from subcutaneous adipose tissue (SC-ASCs). BFP-ASCs isolated from a small amount of tissue were characterized for their stemness and multidifferentiative ability. They showed an important clonogenic ability and the typical mesenchymal stem cell immunophenotype. Moreover, when properly induced, osteogenic and adipogenic differentiation markers, such as alkaline phosphatase activity, collagen deposition and lipid vacuoles formation, were promptly observed. Growth of both BFP-ASCs and SC-ASCs in the presence of human serum and their adhesion to natural and synthetic scaffolds were also assessed. Both types of ASCs adapted rapidly to human autologous or heterologous sera, increasing their proliferation rate compared to standard culture condition, and all the cells adhered finely to bone, periodontal ligament, collagen membrane, and polyglycol acid filaments that are present in the oral cavity or are commonly used in oral surgery. At last, we showed that amelogenin seems to be an early osteoinductive factor for BFP-ASCs, but not SC-ASCs, in vitro. We conclude that Bichat's fat pad contains BFP-ASCs with stemness features that are able to differentiate and adhere to biological supports and synthetic materials. They are also able to proliferate in the presence of human serum. For all these reasons we propose BFP-ASCs for future therapies of periodontal defects and bone regeneration.
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Affiliation(s)
- Eugenio Broccaioli
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan , Milan, Italy
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Squaquara R, Kim Evans KF, Spanio di Spilimbergo S, Mardini S. Intraoral reconstruction using local and regional flaps. Semin Plast Surg 2012; 24:198-211. [PMID: 22550440 DOI: 10.1055/s-0030-1255337] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Choosing a pedicled flap to reconstruct an intraoral defect depends on the size and the anatomic position of the tissue defect. The goals are to restore form and function and minimize donor site morbidity. Regional pedicled flaps available for intraoral reconstruction are the buccal fat pad flap, facial artery musculomucosal flap, platysma, pectoralis major, temporalis muscle flap, and trapezius flaps. We give a concise illustration of anatomy, our harvesting technique, indications, and eventual pitfalls for each of the six flaps.
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Colletti G, Autelitano L, Rabbiosi D, Bazzacchi R, Marelli S, Bardazzi A, Biglioli F. Sinus lift access in partial maxillectomies. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 117:e233-7. [PMID: 22939319 DOI: 10.1016/j.oooo.2012.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 04/17/2012] [Accepted: 05/09/2012] [Indexed: 11/19/2022]
Abstract
Maxillectomies often result in anatomical defects that need to be reconstructed. In partial maxillectomies, the most significant defect is the formation of an oronasal or oral-antral fistula. This creates discomfort and needs to be addressed secondarily with local or regional flaps. Here, we describe a technique adopted in 8 patients in which limited maxillectomies are carried out in a way that preserves the nasal and sinus mucosa, preventing the formation of fistulas and allowing the use of flaps that would normally carry a high risk of fistula formation. Contemporary bone reconstruction with grafts was used in 2 patients. Sparing the sinus and nasal mucosa during maxillectomies is an easy, safe procedure that can prevent a number of complications and can be recommended in selected cases.
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Engdahl R, Nassiri N, Mina B, Drury J, Rosen R. Superselective microcatheter embolization of hemorrhage after buccal lipectomy. Aesthetic Plast Surg 2012; 36:742-5. [PMID: 22395302 DOI: 10.1007/s00266-012-9878-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 02/02/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Superselective microcatheter angiography and embolization has been shown to be an effective modality for prompt treatment of bleeding from traumatic facial injury and refractory epistaxis when local methods fail to achieve hemostasis. It obviates the need for further surgical exploration and provides precise diagnostic and therapeutic modalities in a minimally invasive manner. Despite this successful profile, its use in treatment of hemorrhagic complications after facial aesthetic surgery is underreported. This report is a unique case of life-threatening hemorrhage after buccal fat pad lipectomy that was successfully treated with superselective microcatheter embolization of internal maxillary artery branches. METHODS A 31-year-old male was transferred to our emergency room from an outside facility with an active intraoral hemorrhage after a buccal lipectomy in which severe bleeding was encountered deep within the buccal space that persisted despite further attempts at surgical exploration. On arrival to the emergency room, the patient demonstrated signs of significant blood loss and had intraoral packing in place tamponading further hemorrhage. RESULTS The patient underwent resuscitation and stabilization with endotracheal intubation for airway protection and was sent emergently to the angiography suite. Superselective angiography was used to study branches of the internal maxillary artery. Superselective embolization using microspheres was then performed on target vessels to control the bleeding. The surgical packing was then removed with no evidence of active bleeding. The patient was transferred to the surgical intensive care unit for further monitoring and was discharged the following day in stable condition. CONCLUSION In the case of refractory surgical measures, superselective microcatheter angiography and embolization provides an alternative to both precisely localize and control severe small-artery bleeding. This may be ideal in cases that otherwise would require extensive dissection and in regions of complex anatomy, both of which can compromise aesthetic outcomes. We demonstrated the use of this method in a case of refractory bleeding after facial lipectomy. The expanding role of superselective angiography and specifically designed embolic agents may play an invaluable role in treatment of arterial injury after aesthetic surgery when local methods fail. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
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Affiliation(s)
- Ryan Engdahl
- Department of Surgery, Lenox Hill Hospital, 100 East 77th Street, New York, NY 10075, USA.
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35
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The use of buccal fat pad in the treatment of oral submucous fibrosis: a newer method. Int J Dent 2012; 2012:935135. [PMID: 22666254 PMCID: PMC3362129 DOI: 10.1155/2012/935135] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 02/16/2012] [Accepted: 02/21/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose of the study. This study was to evaluate the use of buccal fat pad as an interpositioning material in surgical management of oral sub mucous fibrosis. Materials and methods. A series of 8 cases with proven oral sub mucous fibrosis, with mouth opening less than 20 mm, involving the buccal mucosa were treated surgically in the Department of Oral and Maxillofacial Surgery, College of Dental Surgery, Saveetha University, Chennai. Pedicled buccal fat pad was used as an interpositioning material to cover the raw areas in the oral cavity after incision and release of fibrous bands. Results. In 8 patients, the range of pre operative mouth opening was 3–18 mm (mean 14 mm). As the result of the successful surgical procedure, the size of the intra operative mouth opening was ranged from 25–38 mm (mean 33.25 mm). The patients were discharged 5–7 days after the operation. The range of the mouth opening at this time was 25–36 mm (mean 30.63 mm). The results were evaluated using student's t test and found to be statistically significant. The pedicled grafts took up uneventfull.
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Youn T, Lee CS, Kim HS, Lim K, Lee SJ, Kim BC, Nam W. Use of the pedicled buccal fat pad in the reconstruction of intraoral defects: a report of five cases. J Korean Assoc Oral Maxillofac Surg 2012. [DOI: 10.5125/jkaoms.2012.38.2.116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Taegyun Youn
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Choong-Sang Lee
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hye-Sun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyoungmin Lim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Seung-June Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
| | - Bong Chul Kim
- Department of Oral and Maxillofacial Surgery, Daejeon Dental Hospital, College of Dentistry, Wonkwang University, Daejeon, Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Korea
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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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Ahmed Djae K, Li Z, Li ZB. Temporalis muscle flap for immediate reconstruction of maxillary defects: review of 39 cases. Int J Oral Maxillofac Surg 2011; 40:715-21. [PMID: 21550782 DOI: 10.1016/j.ijom.2011.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 01/20/2011] [Accepted: 03/04/2011] [Indexed: 11/29/2022]
Abstract
This study evaluated the advantages and complications associated with immediate reconstruction of maxillary defects after maxillectomy and the relationship between defect tissues classification and postoperative results after using the temporalis muscle flap. In this retrospective study, the records of 39 patients who underwent immediate reconstruction surgery using temparolis myofascial flap following maxillectomy from April 1989 to February 2009 were reviewed. Demographic data, features of the disease, follow-up, outcome and complications were analysed. Patients were classified into three groups, to ascertain the influence between defect classification and functional results, aesthetic outcomes and complications in each group. Of the 39 cases, all tissue flaps survived. 5 patients underwent postoperative radiotherapy, which did not seem to influence the outcome of the reconstructive procedure. There was one case of oroantral fistula, which could easily be obturated with the prosthesis. One patient developed haematoma in the donor site 5 days after surgery. Postoperative speech was good, facial appearance was normal and ocular function remained unchanged. Postoperative aesthetic and functional results were satisfying. The temporalis muscle flap can be considered as a first-line reconstructive option for maxillary defects. Acceptable functional and aesthetic outcomes can be expected in high rates.
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Affiliation(s)
- K Ahmed Djae
- Department of Oral and Maxillofacial surgery, School and Hospital of Stomatology, Wuhan University, China
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Mohan S, Kankariya H, Harjani B. The use of the buccal fat pad for reconstruction of oral defects: review of the literature and report of cases. J Maxillofac Oral Surg 2011; 11:128-31. [PMID: 23730057 DOI: 10.1007/s12663-011-0217-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 03/22/2011] [Indexed: 11/30/2022] Open
Abstract
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 pre malignant lesions. This report describes experience with this technique.
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Affiliation(s)
- Shishir Mohan
- K. D. Dental College & Hospital, NH 2 Chatikara, Mathura, 281006 Uttar Pradesh USA
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Buccal pad of fat and its applications in oral and maxillofacial surgery: a review of published literature (February) 2004 to (July) 2009. ACTA ACUST UNITED AC 2010; 110:698-705. [DOI: 10.1016/j.tripleo.2010.03.017] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 03/12/2010] [Accepted: 03/14/2010] [Indexed: 11/22/2022]
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Nguyen C, Young S, Kretlow JD, Mikos AG, Wong M. Surface characteristics of biomaterials used for space maintenance in a mandibular defect: a pilot animal study. J Oral Maxillofac Surg 2010; 69:11-8. [PMID: 21055856 DOI: 10.1016/j.joms.2010.02.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Revised: 09/24/2009] [Accepted: 02/12/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate the effect of implant porosity on wound healing between solid and porous implants placed within a bony mandibular defect with intraoral exposure. MATERIALS AND METHODS Solid poly(methyl methacrylate) (PMMA) implants similar to those used currently in clinical space maintenance applications in maxillofacial surgery were compared with poly(propylene fumarate) implants that contained a porous outer surface surrounding a solid core. A 10-mm diameter nonhealing bicortical defect with open communication into the oral cavity was created in the molar mandibular region of 12 adult male New Zealand white rabbits. Of the 12 rabbits, 6 received the hybrid poly(propylene fumarate) implants and 6 received the solid PMMA implants. At 12 weeks, the rabbit mandibles were harvested and sent for histologic staining and sectioning. RESULTS Gross inspection and histologic examination showed all 6 poly(propylene fumarate) implants to be intact within the defect site at the termination of the study period, with 3 of the 6 specimens exhibiting a continuous circumferential soft tissue margin. In contrast, 5 of the 6 PMMA-implanted specimens were exposed intraorally with an incomplete cuff of soft tissue around the implant. One of the PMMA-implanted specimens exhibited complete extrusion and subsequent loss of the implant. Fisher's exact test was used to compare the occurrence of oral cavity wound healing between the 2 groups (P = .09). CONCLUSIONS Although statistically significant differences between the 2 groups were not seen, our results have indicated that advantages might exist to using porous implants for space maintenance. Additional study is needed to evaluate these findings.
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Affiliation(s)
- Charles Nguyen
- Resident in Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA
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Farré-Guasch E, Martí-Pagès C, Hernández-Alfaro F, Klein-Nulend J, Casals N. Buccal Fat Pad, an Oral Access Source of Human Adipose Stem Cells with Potential for Osteochondral Tissue Engineering: An In Vitro Study. Tissue Eng Part C Methods 2010; 16:1083-94. [DOI: 10.1089/ten.tec.2009.0487] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Elisabet Farré-Guasch
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, International University of Catalonia, Barcelona, Spain
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, International University of Catalonia, Barcelona, Spain
| | - Carles Martí-Pagès
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, International University of Catalonia, Barcelona, Spain
- Hospital Clínic de Barcelona, Barcelona, Spain
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, International University of Catalonia, Barcelona, Spain
- Institute of Maxillofacial Surgery and Implantology, Teknon Medical Center, Barcelona, Spain
| | - Jenneke Klein-Nulend
- Department of Oral Cell Biology, Research Institute MOVE, ACTA-University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - Núria Casals
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, International University of Catalonia, Barcelona, Spain
- CIBER Institute of Physiopathology of Obesity and Nutrition (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
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The Versatility of the Buccal Fat Pad Flap for Reconstruction of Intraoral Defects: The University of Illinois at Chicago Experience. J Oral Maxillofac Surg 2010. [DOI: 10.1016/j.joms.2010.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Giudice M, Giudice A, Colangeli W, Cristofaro MG. The buccal fat pad in recostruction of malignant lesions of the oral cavity: our experience on 31 cases. BMC Geriatr 2010. [PMCID: PMC3290203 DOI: 10.1186/1471-2318-10-s1-a59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Tamura E, Okada S, Shibuya M, Iida M. Comparison of fat tissues used in intracordal autologous fat injection. Acta Otolaryngol 2010. [DOI: 10.3109/00016480903168074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A review of the gross anatomy, functions, pathology, and clinical uses of the buccal fat pad. Surg Radiol Anat 2009; 32:427-36. [DOI: 10.1007/s00276-009-0596-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Accepted: 11/10/2009] [Indexed: 10/20/2022]
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Hassani A, Khojasteh A, Alikhasi M, Vaziri H. Measurement of volume changes of sinus floor augmentation covered with buccal fat pad: a case series study. ACTA ACUST UNITED AC 2008; 107:369-74. [PMID: 18996030 DOI: 10.1016/j.tripleo.2008.08.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 08/20/2008] [Accepted: 08/31/2008] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the volumetric changes of the maxillary sinus graft in conjunction with buccal fat pad (BFP) covering the lateral sinus wall. STUDY DESIGN In this article, the radiographic results are presented on 11 consecutively treated patients using an equal mixture of the autogenous bone harvested from the tuberosity and natural bone mineral (Bio-Oss) used to augment the maxillary sinus. Buccal fat pad was used over the lateral sinus wall in all cases as a membrane to cover the augmentation material. The mean initial bone height (IBH) was 3.82 mm as measured in the posterior maxilla. Three months after sinus elevation, radiographic evaluation was performed for the patients and secondary bone height was measured (SBH(1)). Fifty-two implants were placed in augmented sinuses. Prosthetic rehabilitation of the patients was done 4 months after inserting the implants. Radiographs were taken 6 months after implant placement and secondary bone height was measured (SBH(2)). RESULTS Of 52 implants, 51 (98%) were considered clinically successful. One implant was removed because of mobility at the time of surgical exposure. Clinically, no complications were observed, and all implants were considered clinically osseointegrated after 6 months. Mean bone height was measured as 3.82 mm before sinus grafting. SBH(1) and SBH(2) were measured as 12.22 mm and 10.5 mm respectively. CONCLUSION The clinical findings suggested that BFP might be a substitute for bioresorbable collagen membranes in maxillary and sinus floor bone grafts.
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Affiliation(s)
- Ali Hassani
- Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Tehran, Iran
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El Haddad SA, Abd El Razzak MY, El Shall M. Use of pedicled buccal fat pad in root coverage of severe gingival recession defect. J Periodontol 2008; 79:1271-9. [PMID: 18597611 DOI: 10.1902/jop.2008.070176] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Gingival recession in its localized or generalized form is an undesirable condition resulting in root exposure. Sites exhibiting Miller Class IV gingival recession are not suitable for treatment with surgical root coverage techniques, and their prognoses are very poor with current techniques. The aim of this case report is to establish a new technique for the root coverage of severe gingival recession defects (Miller Class IV) by providing a new source of enough tissue with good blood supply using the pedicled buccal fat pad (PBFP). METHODS The PBFP was mobilized through an incision in the base of the buccal flap at the level of the upper second molar; the vascularized flap was secured to the buccal surface of the upper first molar tooth and premolar teeth and sutured with the wound margins. RESULTS A clinically significant amount of keratinized gingiva that covered the root recession defect was obtained. Epithelialization of the buccal fat pad was completed after 6 weeks, with formation of healthy-looking keratinized mucosa in the anatomic site of the keratinized gingiva. CONCLUSIONS The PBFP technique is simple and easy to handle. It may also be considered a novel application with promising results for the root coverage of severe gingival recession defects (Miller Class IV) that may provide a considerable amount of keratinized tissue used for root coverage of the upper posterior molar teeth.
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Affiliation(s)
- Sally A El Haddad
- Department of Maxillofacial and Diagnostic Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Tamura E, Fukuda H, Tabata Y, Nishimura M. Use of the buccal fat [corrected] pad for vocal cord augmentation. Acta Otolaryngol 2008; 128:219-24. [PMID: 17882561 DOI: 10.1080/00016480701477651] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION We performed therapeutically successful intracordal injection of autologous fat harvested from the buccal fat pad. OBJECTIVE Autologous fat has been used increasingly for intracordal injection as vocal rehabilitation in patients with deficient glottal closure. Adipose tissues used have been harvested mostly from the lower abdomen. However, patients differ considerably in the amount of fat available from the lower abdomen, and it is often difficult to obtain sufficient fat in patients with a low body mass index (BMI). Moreover, the scar visible after harvesting can be cosmetically undesirable. As an alternative, we evaluated harvesting of the buccal fat pad, as in plastic surgery. PATIENTS AND METHODS From January to December 2005, intracordal buccal fat injection was performed for 10 patients, who were subsequently followed up for over 6 months. Buccal mucosa was incised under general anesthesia to expose and harvest the buccal fat pad. This fat was cut into small pieces and injected into the vocal cord. Maximum phonation time and glottal aerodynamics were evaluated pre- and postoperatively. Glottal closure and mucosal vibration were examined stroboscopically. RESULTS Except in one patient, no postoperative complications such as swelling or infection followed either harvesting or injection. After injection, phonation showed notable improvement that was maintained throughout follow-up.
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Affiliation(s)
- Etsuyo Tamura
- Department of Otorhinolaryngology, Tokai University School of Medicine, Tokai University Tokyo Hospital, Tokyo, Japan.
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Tamura E, Fukuda H, Kusuyama T, Okada S, Iida M. Use of the Buccal Fat Pad for Vocal Fold Injection. ACTA ACUST UNITED AC 2008; 111:91-5. [DOI: 10.3950/jibiinkoka.111.91] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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