Use of Buccal Fat Pad Flap in Treatment of Bisphosphonate-related Osteonecrosis of the Jaws (BRONJ): Literature Review and Report of 15 Cases

Objective: to describe the successful treatment of a 5mm-sized granular cell ameloblastoma in the posterior region of the maxilla, discovered in a routine examination during the evaluation of an oroantral communication. Patients and methods: the case repot is presented based on a simple literature review of the last 10 years with the descriptors (Ameloblastoma; Maxilla; Surgery; Oral Diagnosis; Neoplasms) in Pubmed. Treatment consisting of fistulectomy and closure of the oroantral communication with the buccal fat pad and vestibular flap was associated with enucleation and curettage of the adjacent lesion under local anesthesia. Results: a satisfactory evolution was observed in the 1 year postoperative, with a good healing aspect and no signs of oroantral complications or recurrence of the lesion. Conclusion: for minor lesions, more conservative treatment proposals such as enucleation represent a viable alternative and, in addition, the use of adjuvant techniques such as curettage can offer benefits when the differential diagnosis includes more aggressive lesions or with a higher rate of recurrence.

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Outcomes of sequestrectomy and buccal fat pad reconstruction in the management of medication-related osteonecrosis of the jaws

Oral and Maxillofacial Surgery ◽

10.1007/s10006-021-00973-9 ◽

2021 ◽

Author(s):

Anson Jose ◽

Aditi Rawat ◽

Shakil Ahmed Nagori ◽

Saurav Arya ◽

Deepak Shukla

Keyword(s):

Fat Pad ◽

Buccal Fat Pad ◽

Osteonecrosis Of The Jaws

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USE OF BUCCAL FAT PAD IN EXTENSIVE BISPHOSPHONATE-RELATED OSTEONECROSIS OF THE JAWS

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2019.06.067 ◽

2020 ◽

Vol 129 (1) ◽

pp. e28

Author(s):

ISADORA PEREIRA GOMES ◽

POLIANNE ALVES MENDES NASCIMENTO ◽

EDUARDO MORATO DE OLIVEIRA ◽

JOSÉ ALCIDES ALMEIDA ARRUDA ◽

MARIA CÁSSIA FERREIRA DE AGUIAR ◽

...

Keyword(s):

Fat Pad ◽

Buccal Fat Pad ◽

Osteonecrosis Of The Jaws

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Surgical Treatment of Bisphosphonate-Related Osteonecrosis of the Jaws with the Use of Buccal Fat Pad: Case Report

Brazilian Dental Journal ◽

10.1590/0103-6440201301918 ◽

2015 ◽

Vol 26 (3) ◽

pp. 317-320 ◽

Cited By ~ 3

Author(s):

Luiz Fernando Mathias Duarte ◽

Kleber Alonso ◽

Elaine Cristina Basso ◽

Luciano Lauria Dib

Keyword(s):

Surgical Treatment ◽

Metastatic Breast ◽

Bone Area ◽

Fat Pad ◽

Buccal Fat Pad ◽

Necrotic Bone ◽

Osteonecrosis Of The Jaws ◽

Oral Communications ◽

Oral Deformities ◽

Bone Exposure

Bisphosphonate-related osteonecrosis of the jaws (BROJ) has been described since 2003 as an adverse effect of bisphosphonate medications. These drugs act on the vasculature and bone remodeling, mainly on osteoclastic activity and can cause areas of necrotic bone exposure. Treatment for the BROJ is not yet defined, but surgical treatment is one of the forms proposed, which may cause oral deformities like sinus communication in some cases. In situations like this the buccal fat pad is an important alternative for coating nasal-oral communications, due its large blood supply, elasticity, absence of restriction by age and safety. This paper presents the case of a 58-year-old woman with BROJ in the left maxilla caused by the use of zoledronic acid for metastatic breast cancer. The extensive necrotic bone area was surgically removed resulting in oral sinus communication. A buccal fat pad was used to cover the defect. More studies should be performed regarding the treatment of BROJ but, if necessary, a buccal fat pad flap could be an alternative to solve nasal-oral communications related to BROJ.

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