J Korean Assoc Oral Maxillofac Surg.  2012 Apr;38(2):116-120. 10.5125/jkaoms.2012.38.2.116.

Use of the pedicled buccal fat pad in the reconstruction of intraoral defects: a report of five cases

• Youn T
• Lee CS
• Kim HS
• Lim K
• Lee SJ
• Kim BC
• Nam W

• KMID: 2189710
• DOI: http://doi.org/10.5125/jkaoms.2012.38.2.116

Abstract

The buccal fat pad is specialized fat tissue located anterior to the masseter muscle and deep to the buccinator muscle. Possessing a central body and four processes it provides separation allowing gliding motion between muscles, protects the neurovascular bundles from injuries, and maintains facial convexity. Because of its many advantageous functions, the use of the buccal fat pad during oral and maxillofacial procedures is promoted for the reconstruction of defects secondary to tumor resection, and those defects resulting from oroantral fistula caused by dento-alveolar surgery or trauma. We used the pedicled buccal fat pad in the reconstruction of intraoral defects such as oroantral fistula, maxillary posterior bone loss, or defects resulting from tumor resection. Epithelization of the fat tissue began 1 week after the surgery and demonstrated stable healing without complications over a long-term period. Thus, we highly recommend the use of this procedure.

Keyword

Buccal fat pad; Oral reconstruction; Oroantral fistula

MeSH Terms

Adipose Tissue
Masseter Muscle
Muscles
Oral Surgical Procedures
Oroantral Fistula

Figure

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  Fig. 1 Case 1. A. Preoperative dental panoramic X-ray. B. Intraoral view of oroantral fistula. C. Closed the oroantral fistula with buccal fat pad (size: 1×1 cm). D. One week after the operation. There was no bleeding and dehiscence.

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  Fig. 2 Preoperative dental computed tomography image of case 2. Oroantral fistula was detected in the #27 area.

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  Fig. 3 Case 2. Primary closure with buccal fat pad measuring 1.5×1 cm (photographed using dental mirror).

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  Fig. 4 Preoperative computed tomography image of case 3 (horizontal view). Sequestrum was detected around the #25 root area.

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  Fig. 5 Case 3. A. Primary closure with buccal fat pad after the extraction of #25 and sequestrectomy of that area (size: 2.5×2 cm). B. One week after the operation.

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  Fig. 6 Case 4. A. Reddish lesion on the posterior left buccal cheek area. B. Intraoral view after the resected tumor. C. Reconstruction with buccal fat pad after tumor resection. D. One week after operation (superficial necrosis was detected, but there was no dehiscence and bleeding).

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  Fig. 7 Case 5. A. Reconstruction of the posterior maxilla with buccal fat pad. B. One week after the operation. C. Three months after the operation. Epithelization was secured completely.

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