Clinical and Sonographic Analysis of Biometric Indicators of Cheek Thickness and Cheek Fat Body in Patients with Different Face Types

The purpose of the study was to conduct a scientific and practical analysis of clinical sonographic results of examination of patients with different face types in the process of planning the reconstruction of facial soft tissues with the involvement of buccal fat pad. Materials and methods. The study was conducted on 28 patients of different age groups (from 20 to 45 years old) with defects and deformities of the tissues of the dental system. Instrumental sonographic analysis of the thickness of the buccal fat body was performed using an ultrasound scanner GE Logiq E (USA), transducer frequency 7.5-12 MHz. The types of buccal fat pad of correct (oval) or irregular (“hourglass”) shapes were determined, as well as its localization in relation to the median axial location of the crown of the first upper molars and the average value of the buccal fat pad thickness with an accuracy of 0.01 mm. Results and discussion. The results of a clinical study of the average value of the thickness of the cheek of patients with mesofacial type of face allowed to establish that on the left its value is 8.94±0.89 mm, on the right side – 9.05±0.82 mm. In patients with brachyfacial type of face on the left the value of the thickness of the cheek is 12.33±1.63 mm, and on the right side – 12.44±1.54 mm. In patients with dolichofacial type of face on the left, the index of the thickness of the cheek reaches the value of 7.53±0.61 mm, on the right side – 8.58±1.093 mm. Statistical significance was determined in comparison with data from the group of patients with mesofacial facial type. The obtained statistical results show mediocre values of buccal fat pad thickness in patients with mesofacial type of face, which are 1.117 times larger than in dolichofacials and 0.73 times smaller than in brachyfacials, which should be taken into account when conducting sonographic studies. Differences in the quantitative values of buccal fat pad thickness, which are established by clinical and sonographic studies conducted in patients with different types of faces is recommended to take into account when choosing surgical approaches during surgical closure of tissue defects of the alveolar processes of the jaws with autologous buccal fat pad. Conclusion. Buccal fat pad has morphological advantages associated with its saturation with cell complexes that have significant degree of vascularization, pliable texture, plasticity and direct participation in the implementation of the basic functions of the maxillofacial area

Bilateral symmetrical lipoma of the buccal fat pad as an incidental finding in a woman with weight gain after tamoxifen: a case report

Although lipoma is a common benign tumor, it occurs relatively infrequently in the oral and maxillofacial areas, and only 31 cases of lipoma in the buccal fat pad have been reported. Herein, we present an extremely rare case of symmetric lipomas in both buccal fat pads. These masses were incidentally discovered during a facelift procedure in a 50-year-old woman with a 4-year history of tamoxifen use. during which she had gained 10 kg. The patient stated that cheek protrusion had developed concomitantly with weight gain and was exacerbated by an injection lipolysis procedure she had received 1 year previously. This case underscores the importance of paying careful attention to the patient’s medication use and surgical history when evaluating suspected cases of lipoma, and sheds light on tamoxifen use and subcutaneous injections of phosphatidylcholine and deoxycholate as potential risk factors for lipoma development.

AVALIAÇÃO DA MORFOLOGIA DO CORPO ADIPOSO BUCAL: ESTUDO DE REVISÃO

Introdução: O corpo adiposo bucal (CAB) foi descrito pela primeira vez por Heister, em 1732, como uma estrutura glandular, sendo sua natureza gordurosa definida, posteriormente, por Bichat, em 1802. Este tecido possui função mecânica, de proteção e estética, sendo a estrutura responsável pela determinação dos contornos faciais. Contudo, a literatura revela várias aplicações do CAB na reconstrução oral, incluindo o fechamento de defeitos cirúrgicos após a excisão de tumores, cirurgias para remoção de leucoplasias e fibroses submucosas, fechamento de fendas palatinas, cobertura de enxertos ósseos, revestimento da superfície do seio maxilar e reparo celular. Objetivos: Avaliar a morfologia do corpo adiposo bucal. Metodologia: Foi realizada uma revisão de literatura através de bases indexadoras Scielo e PubMed, utilizando os descritores “histology” e “buccal fat pad”. A busca foi realizada sem restrição de idioma da fonte das informações até 06 de setembro de 2021. Foram incluídos nesta pesquisa artigos completos e excluídos cartas ao Editor, opiniões individuais e livros. Resultados: Histologicamente, o corpo adiposo bucal consiste em um estroma de tecido conjuntivo contendo uma população celular heterogênea, dentre as quais podem ser destacadas células-tronco adiposas (ASCs). A literatura ainda indica que tais células podem se diferenciar em várias linhagens celulares, incluindo adipócitos, osteoblastos, condrócitos, miócitos, células neuronais, células endoteliais e hepatócitos. Ainda, o tecido adiposo secreta uma variedade de fatores de crescimento angiogênicos e antiapoptóticos. Muitos estudos demonstraram que produtos derivados de secreções de células-tronco mesenquimais (MSCs) possuem efeitos terapêuticos nos principais processos patológicos associados às funções homeostáticas básicas, como diferenciação e proliferação celular, angiogênese e vasculogênese, inflamação e estresse oxidativo.Cabe ainda ressaltar que, devido a essas propriedades, o corpo adiposo bucal está sendo usado em ensaios clínicos de várias patologias, incluindo doenças imunológicas e opção terapêutica no tratamento de pacientes infectados por SARS-COV-2. Conclusão: O corpo adiposo bucal pode ser considerado fonte de uma população celular heterogênea.

Double-opposing Z-Plasty Extended with a Pedicled Buccal Fat Pad Flap for Correcting Velopharyngeal Insufficiency after Primary Palatoplasty

Introduction Furlow double-opposing Z-plasty (DOZ) lengthens the soft palate; however, this lengthening is achieved at the expense of increased mucosal flap tension. Thus, its use is limited in patients with severe tension applied on mucosal flap after DOZ. In this study, DOZ was combined with a buccal fat pad (BFP) flap to maximize palatal lengthening and muscle repositioning. Methods This study included patients who underwent surgical correction for velopharyngeal insufficiency between December 2016 and February 2019. Patients with more than moderate degree hypernasality following primary palatoplasty were included in the study. Patients younger than 4 years of age, those with a submucous cleft palate, or syndromic patients were excluded. Speech outcomes were investigated for those who underwent DOZ only (DOZ group, n = 17) and those in whom a BFP was used (BFP group, n = 15) pre- and postoperatively. The velopharyngeal gaps between the uvula and pharyngeal wall were measured before and immediately after surgery to estimate the palatal length. Results Most patients who received a BFP showed improvement in hypernasality. However, the hypernasality of the DOZ group was more severe than that of the BFP group (p = 0.023). The extent of palatal lengthening was 4.4 ± 1.7 mm and 7.5 ± 2.1 mm in the DOZ and BFP groups, respectively (p = 0.001). Conclusions BFPs reduced the tension of the DOZ mucosal flap and maximized palatal lengthening and muscle repositioning. They promoted velopharyngeal closure in patients with moderate and moderate-to-severe velopharyngeal insufficiency. Hence, our method improves the surgical outcomes of patients with velopharyngeal insufficiency after primary palatoplasty.

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.