Versatility of Buccal Pad of Fat in the Reconstruction of Oral and Maxillofacial Defects - A Review

BACKGROUND The maxillofacial region has several congenital and acquired defects. Because of its abundant blood supply and proximity to different intraoral abnormalities, the buccal fat pad flap (BFP) is a simple and reliable flap that can be used to repair a variety of these abnormalities. BFP has remarkable qualities as a scaffold and autogenous dressing in the healing of intraoral defects after excision of oral cavity intraoral lesions. Filling and allowing slippage of fascial spaces between muscles of facial expression, advancement of intermuscular motion, isolating mastication muscles from one another, counteracting negative pressure during suction in the newborn, protection and cushioning of neurovascular bundles from injuries are among the functions of BFP. It also has a dense venous network that facilitates exoendocranial blood flow via the pterygoid plexus. For many years, the BFP was considered a surgical annoyance due to its incidental encounter during various surgeries in the pterygomaxillary space or following injuries to the craniofacial region. However, various clinical applications of BFP have been introduced in recent years. We looked at BFP and its anatomical foundation, surgical procedures, and clinical applications in this review article. The surgical method is easy and effective in a wide range of clinical situations, including oroantral fistula closure, congenital defect rectification, Osteoradionecrosis treatment, and reconstruction of tumor or cyst defect. Thus BFP is a dependable flap that may be used in a variety of therapeutic conditions. KEY WORDS Buccal Fat Pad Flap; Oral Mucosa; Reconstruction; Defect.

Use of buccal fat pad flap for premalignant buccal mucosa defect reconstruction

Premalignant lesions over buccal mucosa are very common in India, some of these lesions require excision leaving behind defects and various techniques can be used in reconstruction of these defects. Small palatal defect, oroantral fistulas have been successfully closed by buccal pad of fat flap. Aim of this study was to evaluate reconstruction of defects after excision of premalignant lesion over buccal mucosa using buccal pad of fat. 20 patients were selected for this study who presented with different premalignant lesions like erythroplakia, proliferative verrucous leukoplakia, chronic hyperplastic candidiasis, Oral submucous fibrosis over buccal mucosa in Dr. DY Patil medical college surgery unit 4 and 7. Excision of lesion followed by reconstruction with buccal pad of fat was done. Patients were followed up every 14 days for 14 weeks, and was evaluated for epithelisation of flap and post-operative complications like infection and flap necrosis and also the functionality of the flap. In this study we have observed complete epithelisation of the flap in most of our patients. Dehiscence of the wound was observed in 3 of the patients with large defects (>4×5 cm). No postoperative morbidity was in postoperative patients. Buccal pad of fat is an excellent technique for reconstruction of small defects of buccal mucosa. It is a reliable and a fast method which has easy accessibility less complications and minimal morbidity.