CASE REPORT   

European Journal of Oral and Maxillofacial Surgery 2021 August;5(2):58-61

DOI: 10.23736/S2532-3466.20.00210-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Surgical management of medication related osteonecrosis of the jaws using buccal fat pad

Abdessamad OUAKIL ✉, Akram BELMEHDI, Karima EL HARTI

Center of Dental Consultation and Treatment, Department of Oral Surgery, Faculty of Dental Medicine, Mohammed V University, Rabat, Morocco

Bisphosphonates are commonly prescribed antiresorptive agents for the management of patients with osteoporosis, Paget’s disease, multiple myeloma, and metastatic tumors. Because of their effect on bone remodeling, these drugs can cause the onset of osteonecrosis in the jaws. Along with other drugs, these conditions have been classified as medication related osteonecrosis of the jaws (MRONJ) and represent a particular condition difficult to manage in oral surgery. In case of maxillary localization, the osteonecrosis can extend towards the maxillary sinus and cause an oroantral communication. The resulting bone defect is difficult to manage by conventional techniques especially after surgical debridement. The buccal fat pad function to fill the deep tissue spaces, to act as gliding pads when masticatory and mimetic muscles contract, and to cushion important structures from the extrusion of muscle contraction or outer force impulsion. The buccal fat pad can be divided into three lobes with several nutritional vessels in each lobe and in the subcapsular vascular plexus forms which make it a good donor in translated flaps. The aim of this case report was to describe the surgical use of buccal fat pad in management of MRONJ defect and to emphasize the interest of this flap in the management of maxillary location of this condition.

KEY WORDS: Bisphosphonate-associated osteonecrosis of the jaw; Adipose tissue; Tissue transplantation; Osteonecrosis; Surgical procedures, operative; Oroantral fistula