Use of Buccal Fat Pad in the Treatment of Peri-Implant Mucosal Defect: A Case Report
The present study describes a clinical case in which the buccal fat pad (BFP) was used to improve the contour of the peri-implant mucosa. To our knowledge, this is the first case report of such an application in the literature. A 58-year-old woman presented with teeth #2 and #3 missing and an indication for extraction of tooth #4. After clinical examination and CBCT analysis, immediate implants were placed in the region of the extracted tooth and that of tooth #2 for prosthetic rehabilitation using a three-unit fixed partial denture. There was an extensive mucosal defect in the region of tooth #3, with vertical and horizontal changes in the contour of the mucosa. As an alternative to the use of a subepithelial connective tissue graft, we opted for displacement of the BFP and its accommodation on the alveolar ridge of tooth #3 to improve the buccal tissue contour. After 5 years of follow-up, satisfactory gain and maintenance of mucosal volume were observed in the treated area, as well as improvement of buccal tissue contour. The use of BFP seems to be a feasible alternative for filling and treating peri-implant mucosal defects.
Figure 1. Change in tissue contour in the region corresponding to tooth #3. Figure 2. Immediate implant placement at the extraction site of tooth #4 and in the region of tooth #2. Periosteal incision on the buccal flap in the region of tooth #2 to gain access to the buccal fat pad. Figure 3. Divulsion and pulling of the buccal fat pad to accommodate it on the bone ridge.
Figure 4. Soft tissue contour after 60 days. Figure 5. Clinical control after 5 years. Note the vertical and horizontal maintenance of mucosal tissue volume. Figure 6. Clinical control after 5 years. Figure 7. Radiographic control after 5 years.
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