Buccal fat pad to obtain and maintain primary closure and to improve soft tissue thickness at boneaugmented sites: technique presentation and report of case series

Purpose: Atrophic ridges usually have both hard and soft tissue shortages, and bone augmentation can make soft tissue closure difficult. The aim of this case series is to present a new method utilizing transfer of free fat tissue grafts (FFG) from the buccal fat bad (BFP) during bone augmentation to enhance immediate primary soft tissue closure and improve long-term soft tissue thickness and quality at the recipient site.

Materials and Methods: Patients with moderate to severe ridge atrophy in different regions of the jaws were treated over a 4-year period with bone augmentation and FFG. The BFP was the donor site for the FFG. Patients were examined clinically and radiographically (periapical) every 2 weeks. At 4 months, computed tomography was performed to evaluate the bone gain. Reentry was performed after 4 to 5 months to evaluate the soft tissue, obtain specimens for histologic examination, and insert implants.

Results: Twenty patients (18 women, 2 men; mean age 43 years) were followed for 4 to 42 months and received 92 implants in the augmented sites. The healing process was uneventful, with minimal morbidity. Bone volume increased by 4 to 8 mm horizontally and 3 to 6 mm vertically. Thick soft tissue was obtained at the recipient sites and around the dental implants, and histologic specimens showed that the FFG was replaced by fibrous tissue.

Conclusions: Harvesting of the FFG from the BFP is a simple procedure with minor complications, and manipulation and handling of the graft are easy. The FFG enhances primary soft tissue closure of augmented bone, prevents dehiscences, improves long-term soft tissue thickness, and mimics the attached gingiva in its fibrous healing.

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