Use of buccal fat pad to repair post-extraction peri-implant bone defects in the posterior maxilla. A preliminary prospective study

María Peñarrocha-Diago, Rocío Alonso-González, Amparo Aloy-Prósper, David Peñarrocha-Oltra, Fabio Camacho, Miguel Peñarrocha-Diago, María Peñarrocha-Diago, Rocío Alonso-González, Amparo Aloy-Prósper, David Peñarrocha-Oltra, Fabio Camacho, Miguel Peñarrocha-Diago

Abstract

Background: Extensive literature exists about the use of the BFP in the treatment of oral defects but, to our knowledge, no article refers to the use of the BFP as a substitute of the membrane barriers for treatment of peri-implant bone defects. The aim was to evaluate the use of the buccal fat pad as a coating material for bone grafting in the peri-implant bone defect regeneration of immediate implants placed in the posterior maxilla.

Material and methods: A preliminary prospective study of patients involving immediate implants in which the buccal fat pad was used as a coating material to peri-implant bone defects was carried out. The outcome measures assessed were: postoperative pain and swelling, complications related to buccal fat pad surgery, implant survival and success rates and peri-implant marginal bone loss at 12 months of prosthetic loading.

Results: Twenty-seven patients (17 women and 10 men) with a mean age of 55.3 ± 8.9 years, and a total of 43 implants were included. Two-thirds of the patients reported either no pain or only mild intensity pain and moderate inflammation, two days after surgery. Post-operative period was well tolerated by the patients and no serious complications occurred. None wound dehiscence occurred. Implant survival and success rates were 97.6% and the average marginal bone loss 1 year after loading was 0.58 ± 0.27 mm.

Conclusions: Within the limits of this preliminary study, the use of the buccal fat pad as a coating material for bone grafting in peri-implant bone defects placed in the upper posterior maxilla was a well-tolerated technique by patients; high implant success rate was achieved with a minimal peri-implant marginal bone loss at 12 months of prosthetic loading.

Conflict of interest statement

Conflict of interest statement: The authors have declared that no conflict of interest exist.

Figures

Figure 1
Figure 1
A) Post-extraction sockets corresponding to 1.5 and 1.6 positions. B) Post-extraction alveolar bone defects visualized after flap elevation. C) Dental implants placement. Buccal fat pad is placed by covering particulate bone graft. D) Suture. Buccal fat pad is left exposed to the oral environment. E) Panoramic radiography taken at dental implants placement. F) Healed soft tissues. G) Final prosthesis placement. H) Panoramic radiography taken at prosthesis placement. I) Twelve-month control panoramic radiograph.
Figure 2
Figure 2
Surgical technique scheme. Sagittal view. A) Molar to be extracted. B) Immediate implant placed. C) Placement of bone graft over peri-implant defect. D) BFP buccal extension is pulled and placed over the bone graft. E) Mucoperiosteal flap replacement over buccal fat pad pedicle. Suture.
Figure 3
Figure 3
Average mean of pain levels during the first 7 postoperative days.
Figure 4
Figure 4
Average mean of inflammation levels during the first 7 postoperative days. Legends: a) none (no swelling); b) light (intraoral swelling, localized to the treated area); c) moderate (extraoral swelling extending beyond the treated area), d) severe (extraoral swelling extending beyond the treated area).

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