Surgical oncology and reconstruction
Use of Buccal Fat Pad for Treatment of Oral Submucous Fibrosis

https://doi.org/10.1016/j.joms.2011.02.089Get rights and content

Purpose

The aim of this study was to clinically evaluate the application of pedicled buccal fat pad (BFP) in the surgical management of stage III and IV oral submucous fibrosis (OSMF).

Materials and Methods

Twenty-eight cases of clinically and histologically diagnosed cases of OSMF were divided into 2 groups: group I (n = 15) and group II (n = 13), corresponding to clinical stage III and stage IV, respectively. All the patients underwent incision of fibrotic bands and coverage of the buccal defect with a pedicled BFP flap. Both groups were analyzed separately for mouth opening (interincisal distance in millimeters) preoperatively and 1 year postoperatively, time taken for epithelialization of BFP, time taken for establishment of normal contour, and changes in symptoms (painful ulcerations, burning sensation, and intolerance to spices) 1 year after grafting.

Results

The mean preoperative mouth opening was 19.6 mm (SD, 2.43) in group I and 12.92 mm (SD, 1.21) in group II. The mean postoperative mouth opening after 1 year was 35 mm in group I (SD, 1.96) and 31.76 mm in group II (SD, 1.97). The time taken for epithelialization of BFP was 4 weeks in group I and 5 weeks in group II. The mean time taken for establishment of normal contour after grafting was 12.25 weeks (SD, 1.42) in group I and 15.07 weeks (SD, 1.26) in group II. In 2 cases in group II, there was remission of painful ulcerations, burning sensation, and intolerance to spices.

Conclusion

BFP is reliable for the treatment of OSMF.

Section snippets

Materials and Methods

All patients who presented to the department of oral and maxillofacial surgery at our institute to seek treatment for chief complaints of reduced mouth opening, painful ulcerations, burning sensation, intolerance to spices, and a habit of betel nut or tobacco chewing were screened for clinical diagnosis of OSMF. On the basis of clinical findings, the patients were grouped into 4 categories1: stage I, interincisal mouth opening of more than 35 mm; stage II, interincisal mouth opening from 26 to

Results

In our study 28 patients were divided into 2 groups: group I (stage III) consisted of 15 patients and group II (stage IV) consisted of 13 patients with a mean preoperative mouth opening of 19.6 mm (SD, 2.43) and 12.92 mm (SD, 1.21), respectively. The mean postoperative mouth opening after 1 year was 35 mm in group I (SD, 1.96) and 31.76 mm in group II (SD, 1.97) (Fig 2). There was no evidence of graft failure, but recurrence of trismus and no remission of painful ulceration, burning sensation,

Discussion

OSMF is an insidious, chronic disease that may affect any part of the oral cavity and sometimes the pharynx, leading to stiffness of the oral mucosa and causing trismus.1, 3 This disease is most frequently found in India and is not uncommon in Southeast Asia. It has also been reported in other countries because immigration has resulted in a worldwide distribution. Betel nut chewing appears to be the main factor correlating with this disease.12

Most patients complain of an irritable oral mucosa

References (16)

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