Anatomical and Surgical Implications of the Usage of Bichat Fat Pad in Oroantral Communication, Maxillary, Palatal, and Related Surgeries—Narrative Review

Abstract

The buccal fat pad, also called the Bichat’s fat pad (BFP), is an encapsulated fat mass located in the cheek. This type of specialized fat mass can be used both as a pedicular or free graft in various surgeries and approaches. Due to its easy access from the oral cavity approach, it is commonly used for oroantral and palatal fistula closure. The knowledge of its anatomy and surrounding tissues plays a role in its mobilization and suturing onto the desired defect in the palatal or maxillary region. The BFP is mostly associated with the primary approach used for a fistula or bone surgery. Alternatively, the procedure can be performed with a single approach incision, which does not compromise the appearance or the function of the operating or adjacent areas. The most important inclusion criteria for BFP usage and surgical limitations are highlighted. The BFP is used for multiple purposes in reconstructive and oncology surgery and also has its use in esthetic and facial contouring procedures. The amount, volume, and shape of the BFP are mostly associated with the scope of their usage. The aim of the following narrative review is to present the surgical and anatomical implications of fat pads in maxillary and palatal surgeries.

Treatment of Odontogenic Maxillary Sinusitis with the Use of Growth Factors in Advanced Platelet-Rich Fibrin for Immediate Closure of Oro-Antral Communication: A Case Report

“…A distinctive advantage of utilizing the BFP by itself is its non-interference with the oral vestibule, which facilitates subsequent denture placement without complication. Although this approach is generally well-received by patients, it is important to note that it can only be applied once per treatment side, limiting its repeatability [45,46]. Other less popular methods include: autogenous distant flaps (tongue flap, auricular cartilage, septal cartilage, temporalis muscle flap), autogenous bone grafts (the bone can be collected extraorally (crest of the iliac plate, fibula, ribs, tibia, skull bones) or intraorally (retromolar triangle area, area between the mandibular foramina, maxillary protuberance, external oblique line in mandible, edentulous section of the jaws (e.g., under the pontic of the bridge), or surgical area)), allogenous (fibrin glue, dura), xenograft (collagen, gelatin film, xenogenous bone grafts and membranes), synthetic materials and metals (gold, aluminum, tantalum, polymethylmethacrylate, hydroxyapatite, root analogue, titanium dental implant), other methods (tooth autotransplantation, interseptal alveolotomy, prolamin gel, splint, prosthetic dentures, biostimulation with laser light) [42,[47][48][49][50].…”

Tópicos da odontologia aplicada - Volume 2

“…Está implicado na formação de bochechas ocas e dobras nasolabiais, mas não na formação de mandíbulas. 1 A cirurgia de bichectomia por ser um lugar anatômico nas estruturas faciais profundas, possíveis complicações incluem: sangramento, infecção, má cicatrização das incisões, hematomas, riscos anestésicos, seroma, parestesia, turgidez prolongado, lesões nos ramos do nervo facial, lesão do ducto salivar, trombose venosa profunda, complicações pulmonares e cardíacas, assimetria, algia persistente e possibilidade de cirurgia reparadora. Portanto devido que a bichectomia vem ganhando cada vez mais espaço, no segmento odontológico, principalmente por ser um procedimento considerado estético dentro da harmonização facial nesse sentido, o presente trabalho apresentou a realização de uma revisão bibliográfica sobre a Bola de Bichat, mostrando que o manejo incorreto pode gerar grande perigos quando o cirurgião-dentista não conhece as estruturas anatômicas que a circundam.…”

“…Maria Taywri Almeida Costa 1 Vinícios Fernando Silva da Silva 1 Bruno Oliveira Silva 2 Lozuel Lemos Tavares 1…”

“…Está implicado na formação de bochechas ocas e dobras nasolabiais, mas não na formação de mandíbulas. 1 A Bola de Bichat é composta de várias partes, embora exatamente quantas partes pareçam ser um ponto de desacordo e nenhuma nomenclatura consistente e única dessas partes tenha sido observada. Tem 6 mm de espessura e um peso médio de 3,9 g na maioria dos casos.…”

Clinical Features of Oroantral Communication Management Using Buccal Fat Pad by Tunnel Method

“…Some authors have noted that the use of BFP for OAC treatment may be limited by possible changes in facial configuration, as the BFP, especially its superficial structures, are involved in the formation of the aesthetic contour of the face. 10,21 Despite the absence of assessment of facial configuration changes in the study objectives, no patient visually intraoperatively and on control examinations after the disappearance of edema was found to have facial configuration changes. This result is supported by the work of Park J. et al (2019), which investigated the effectiveness of OAC treatment with BFP in 25 patients.…”