ABSTRACT
La bolsa adiposa de Bichat está constituida por un cuerpo y tres extensiones de tejido adiposo, se localiza dentro del espacio bucal y seextiende siguiendo el borde anterosuperior del músculo masetero. En la actualidad su uso como colgajo pediculado ha demostrado excelentesresultados en el tratamiento de reconstrucción de defectos postumorales de tejido blando en el paladar. Lo anterior se debe a su gran aporte vascular, composición histológica y a la presencia de células madre en tejido adiposo que fomentan una metaplasia del tejido, convirtiéndose en tejido fibroso y superfi cialmente con epitelio en tan sólo cinco semanas. La técnica de abordaje y reposicionamiento del colgajo pediculado en paladar fue modifi cada con la extirpación de la tuberosidad del maxilar para corregir el defecto ocasionado por un adenoma pleomorfo en el paladar. Se destacan las características y cualidades de la bolsa adiposa de Bichat para su uso en reconstrucción de defectos tumorales.
Bichats buccal fat pad is constituted by a body and three extensions ofadipose tissue within the buccal space and extending to the anteriorsuperiorborder of the masseter muscle. To this days, the use of thebuccal fat pad as a pedicled graft has shown excellent results onoral post tumoral reconstruction treatment. This is due to its greatvascularity, histological composition and perhaps to the presenceof stem cells that promotes a metaplasia, turning adipose tissue intofi brous and superfi cially epithelized tissue within fi ve week aftersurgery. Surgical approach and repositioning technique of the pedicledgraft was modifi ed, extirpating part of the maxillary tuberosity, topreserve vascularity and cover up a hard-soft tissue defect caused by apleomorphic adenoma on a patients palate. Buccal fat pads qualitiesand characteristics are taken into consideration to demonstrate theeff ectiveness on its surgical reconstructive uses.
Subject(s)
Male , Humans , Adult , Adenoma, Pleomorphic/surgery , Adipose Tissue/transplantation , Palatal Neoplasms/classification , Palatal Neoplasms/surgery , Surgical Flaps , Biopsy/methods , Mexico , Oral Surgical Procedures/methods , Stem Cells/physiology , Wound Healing/physiologyABSTRACT
This article reports the role of coronoid process as a free graft and pedicled graft in reconstruction of temporomandibular joint in ankylosis cases. The cases treated were observed clinic-radiologically over a period of 12 months. Various autogenous and alloplastic materials used for reconstruction of TMJ were considered with their advantages and limitations. The use of coronid process for reconstruction of the nose, orbital floor, alveolar ridge and paranasal augmentation has been reported by various authors. Due to its shape and size coronoid process is not a popular option for TMJ reconstruction. The advantage of using coronoid graft is autogenous bone of intramembranous origin harvested through same surgical site. Possibility of graft resorption can be minimized when used as pedicled graft. Postoperative radiograph revealed complete uptake and remodeling of the graft when used both as free and pedicled graft. There was no failure of treatment in terms of reankylosis. Therefore, coronoid process may be a suitable bone resource for condylar reconstruction in patients with TMJ ankylosis.
ABSTRACT