Reconstruction of the maxilla with bone grafts supported by the buccal fat pad

Closure of oro-antral fistula with pedicled buccal fat pad. A case report and review of literature

“…Pedicled buccal fat pad has also been employed in the closure of surgical defects following tumor excision 7 , excision of leukoplakia and submucous fibrosis 15,16 , as well as closure of primary and secondary palatal clefts 9,17 , and coverage of maxillary and mandibular bone grafts 6,18 . Although, no complication was observed in our case, complications in large series range between 3.1-6.9% 4,7,8,19 .…”

The buccal fat pad flap in oral reconstruction

“…The pedicled buccal fat flap has also been used to close oroantral and oronasal fistulae, 15,17,18 to cover the nasal or antral surface of bone grafts used for maxillary reconstruction, 19 as vascularized filling tissue, 5 to cover surface irregularities over bone grafts used for the reconstruction of posttraumatic infraorbital and maxillary defects in cases of overlying thin skin, 5 in association with a cervicopectoral flap to reconstruct the facial contour, 16 and to cover the buccal mucosa in cases of oral submucous fibrosis. 20 The buccal fat pad is important in delineating facial contours, 4 and thus its resection has been used as an aesthetic procedure, because it reduces cheek thickness and increases the projection of the malar prominence.…”

The buccal pad of fat: A review

“…As the parotid duct turns medially, it is often embedded in a furrow of the protruding fat pad (Sicher, 1960). Anteriorly, the fat pad is attached to the muscle fibers of buccinator (Vuillemin et al, 1988). T h e caudal limit is the retromolar area of the mandible (Egyedi, 1977).…”

“…At birth the sucking muscles of the lips, orbicularis oris, and of the cheeks, principally the buccinator, are relatively better developed than the muscles of mastication (Vuillemin et al, 1988). In well-nourished babies the fat pad pushes the buccinator inward and forms a prominent elevation on the external surface of the face.…”

“…Tideman et al (1986) reported 12 cases of closure of deficits with a pedicled graft, one of which failed. Vuillemin et al (1988) described reconstruction of the maxillary contour with a bone graft supported by the buccal fat pad, which allowed the bone to integrate more successfully, as it was separated from the bacterial flora of the antral and nasal cavities. T h e y also reported restoration of physiological function of the epithelialized surface of the fat pad in the maxillary antrum.…”