Non-Pedicled Buccal Fat Pad Grafts to Treatment for Class I and II Gingival Recessions: A Clinical Trial

Abstract

The aim of this study was to analyze the transplant efficiency of non-pedicled buccal fat pad graft (BFPG) for the treatment of Miller Class I or II gingival recessions (GRs) and to compare these results with those of subepithelial connective tissue graft (SCTG), which is considered the gold standard. Twelve patients with Miller Class I or II (≥2 mm) bilateral recessions in maxillary premolars or canines were selected. Recessions were randomly assigned to receive SCTG or BFPG. The clinical parameters evaluated at baseline and at 1, 3, and 6 months postoperatively included gingival index, plaque index, probing depth, GR, clinical attachment level, width of keratinized tissue, thickness of keratinized tissue and gingival margin to the acrylic guide. None of the evaluated clinical parameters differed significantly between the groups. At all evaluated postoperative time-points, both groups exhibited statistically significant differences in GR and gingival margin to the acrylic guide compared to baseline. Six months after surgery, the mean percentages of root coverage were 67.5% and 87.5% in the BFPG and SCTG groups respectively. In both groups, complete root coverage was observed in 50% of cases 6 months after surgery. The results presented herein indicate that the use of BFPG transplant has clinical similarities with SCTG and both may be considered as clinically successful methods for treating Miller Class I and II GRs.

Treatment of Miller Class I Gingival Recession with Using Nonpedicle Adipose Tissue after Bichectomy Surgical Technique: A Case Report

“…In the present case report, a nonpedicled buccal fat pad graft was performed with flap advancement, resulting in complete root coverage, with maintenance of the extension of the keratinized tissue width, normal color and texture characteristics, and a small increase in gingival volume. The results were maintained after one year of follow-up suggesting that the technique is safe and effective, in agreement with a previously performed study [8].…”

“…In 2015, Deliberador et al [8] conducted a split-mouth randomized controlled trial to analyze the transplant efficiency of a nonpedicled buccal fat pad graft for the treatment of Miller Class I and Class II gingival recessions and compared the results with those of a subepithelial connective tissue graft. The authors concluded that the use of a buccal fat pad graft can be considered a predictable alternative, as no significant statistical differences were observed between the two techniques with respect to the esthetic results, gain in clinical attachment level, gain in keratinized tissue, and root coverage; thus, both therapies were considered to be clinically successful.…”

“…Treatments with pedicled buccal fat pad grafts are also described in the literature with satisfactory results regarding root coverage, clinical attachment level, and keratinized tissue gain [6,7]. However, the use of nonpedicled buccal fat pad grafts is still poorly described [8].…”

Complications associated with the bichectomy surgery

“…Despite the buccal fat pad surgical intervention occurs to harmonize the facial contour, as this anatomical structure provides fullness to the cheek and is responsible for the facial contour [7,17], in Dentistry, many other clinical applications for the buccal fat pad use are listed in the literature such as: harmonizing the facial contour in cases of masseter hypertrophy; repairing defects caused by tumor resections, maxillary cysts and oro-antral communication [18][19][20][21][22][23][24][25][26]; post-traumatic defect correction [19][20][21]; reconstruction of the soft palate and the hard palate defects [27]; use as an aesthetic filler to provide lip, premaxilla and paranasal volume [28]; in the malar region [29,30] use as a filler in cases of maxillary sinus membrane perforation [31]. In cases 1 and 3 reported in this research study, the purpose of the surgical intervention was to change the facial contour of the patients, making it softer and more pleasant.…”

Clinical and patient‐centered outcomes using two types of subepithelial connective tissue grafts: A split‐mouth randomized clinical trial

“…Deliberador et al. (2015) 10 compared SCTG removed by L‐shaped incision to non‐pedicled buccal fat pad graft (BFPG) for the treatment of bilateral gingival recessions. Thus, this split‐mouth randomized clinical trial compared clinical and patient‐centered outcomes using two different types of SCTG (DE and DBS) for the treatment of multiple gingival recessions.…”