Conventional fibrotomy and reconstruction with lateral thigh dermal fat pad in grade III oral submucous fibrosis patients: A case report and review of literature (original) (raw)
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International journal of scientific research, 2021
Background, Aim And Objectives: Oral sub-mucous brosis is a chronic progressive premalignant condition, characterized by gradually increasing brosis of sub mucosa resulting in trismus thereby, limiting mouth opening. Various surgical modalities have been tried in the surgical management, but each has its own limitations. In the present study, evaluate buccal fat pad (BFP) graft and without grafting used for reconstruction after release of brosis. Methods: The study group consisted of 20 patients with bilateral clinically diagnosed cases of (OSMF) oral sub-mucous brosis. Treated surgically, Group 1 (buccal fat pad graft) was compared with group 2 (without grafting) post operatively for mouth opening up to 6 months follow up. Results: The distribution of age between the groups, mean age of patients of Group 1 and Group 2 was 28.70±6.78 and 30.40±7.45 years respectively. There was no signicant (p>0.05) difference in age between the groups showing comparability of the groups in terms of age and the distribution of gender between the groups, majority of patients in both Group 1 (80%) and Group 2 (90%) were males. There was no signicant (p>0.05) difference in gender between the groups showing comparability of the groups in terms of gender Conclusion: we concluded that the surgical site in OSMF cases should always be grafted with some graft material and could also be stated that the BFP has proven itself to be a satisfactory option when and wherever required, keeping in view the ease of harvesting and donor site morbidity.
Use of Buccal Fat Pad for Treatment of Oral Submucous Fibrosis
Journal of Oral and Maxillofacial Surgery, 2012
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 ϭ 15) and group II (n ϭ 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.
International Journal of Health Sciences (IJHS), 2022
Aim of the study is to evaluate efficacy and compare the surgical outcome of buccal fat pad and nasolabial flap in increasing postoperative mouth opening in reconstruction of the defect created after excision of fibrous bands in surgically treated cases of OSMF. Materials and Methods: this study included 10 patients who came in our department at Karnavati School of dentistry between the years 2017 and 2020, out of which 5 patients underwent closure of surgical defect using buccal fat pad (Group I) and 5 patients underwent closure of surgical defect using nasolabial flap (Group II). Clinically proven cases of OSMF with mouth opening no more than 20 mm were included in this study. Mouth opening of patients were documented preoperatively, intraoperatively and at 6 months of follow up. Results were tabulated and were analysed by paired t test. Results: in group I and II, there was substantial difference in mouth opening at all periods of follow-up. At 1 month follow-up, mean mouth opening was 29.4 mm in group 2 compared with 28.25 mm in group I. Relevant difference in average mouth opening at the end of 6 months was observed and was 32.6 mm in group II as compared to group I which was 29 mm. Conclusion: Nasolabial flaps are a viable, reliable and a better option, that has withstood the test of time for reconstruction of intraoral defects in oral submucous fibrosis.
2019
Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder of the oral cavity. The surgical management of this condition involves excision of the fibrotic bands and interpositional grafts to retain the increased oral opening. Various procedures and graft material have been utilized with differing success rates. OBJECTIVE: is to collect and analyze from world literature two different techniques that is the buccal fat pad and nasolabial flap in the surgical management of OSMF. The reasons for the choice of a particular surgical procedure, the study protocol, the average follow-up period and the results were analyzed. Study Eligibility Criteria: Inclusion criteria include articles in English literature, articles published between from Jan 2000 to Dec 2017, RCT, and clinical trials. Exclusion criteria includes reviews, case reports, letters, abstracts, editorials, historical reviews and in vitro studies, full text articles not available in spite of writing to authors...
Comparison of Various Surgical Procedures used for Treatment of Oral Submucous Fibrosis
Introduction: Oral submucous fibrosis (OSMF) was first described by SCHWARTZ in 1952 and PINDBORG et al. They estimated there are no fewer than 2,500,000 cases of OSMF in India. OSMF is a collagen disorder commonly seen in the Indian subcontinent. OSMF is of multi factorial origin with high incidence of the disease in association with consumption of the arecanut, arecoline, chillies, tobacco. This study was undertaken to assess the feasibility of various surgical procedures employed to correct the OSMF and results were compared under following headings: Postoperative mouth opening(incisor and molar region), pain, swelling, infection and relapse. Material and methods: This study comprised of 74 patients suffering from OSMF, out of these 74 patients, 34 patients underwent surgery. Out of these 34, 28 cases were followed upto 6 months and 6 cases were followed upto 3 months only. Patients followed upto 6 months are discussed in this study. These patients were divided into 3 groups on the basis of surgical techniques employed to them. Results: Highest inter incisor mouth opening was seen in the group II subjects at 6 months (17.70 ± 3.74) while least opening was seen in group III at the same interval (5.50 ± 9.80) similar findings were seen for the inter-molar mouth opening where group III showed the least mouth opening at 6 months. The final results for the success and relapse of the treatments showed that group I and II had full recovery while in group III only 5 patients could be treated completely while 3 showed relapse. Conclusion: Buccal fat pad grafting was a suitable alternative to tongue flap grafting, and had the advantage of being versatile; simple surgical technique, that can be performed in almost any patient, with acceptable stability in post operative mouth opening.
The use of buccal fat pad in the treatment of oral submucous fibrosis: a newer method
International journal of dentistry, 2012
Purpose of the study. This study was to evaluate the use of buccal fat pad as an interpositioning material in surgical management of oral sub mucous fibrosis. Materials and methods. A series of 8 cases with proven oral sub mucous fibrosis, with mouth opening less than 20 mm, involving the buccal mucosa were treated surgically in the Department of Oral and Maxillofacial Surgery, College of Dental Surgery, Saveetha University, Chennai. Pedicled buccal fat pad was used as an interpositioning material to cover the raw areas in the oral cavity after incision and release of fibrous bands. Results. In 8 patients, the range of pre operative mouth opening was 3-18 mm (mean 14 mm). As the result of the successful surgical procedure, the size of the intra operative mouth opening was ranged from 25-38 mm (mean 33.25 mm). The patients were discharged 5-7 days after the operation. The range of the mouth opening at this time was 25-36 mm (mean 30.63 mm). The results were evaluated using student...
Curēus, 2024
Purpose: To evaluate the effectiveness of nasolabial flap (NLF), a buccal pad of fat flap (BFP), and platysma myocutaneous flap (PMF) for reconstruction following fibrotomy for individuals with oral submucous fibrosis (OSMF). Material and method: A retrospective study was conducted among patients diagnosed with grade III and IV OSMF in the Department of Oral and Maxillofacial Surgery at Sharad Pawar Dental College between January 2016 and August 2018. The essential patient information was obtained from the Medical Record Department (MRD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Sawangi (Meghe) Wardha. The patients were categorized into three groups: the NLF, the BFP, and the PMF groups. Each group had 16 patients, and factors such as interincisal width, diminished burning sensation in the mouth, inter-commissure distance, and flap necrosis were compared pre-and postoperatively. Student's unpaired t-test and chi-square test were employed for statistical analysis. Result: Mean interincisal mouth-opening increased from pre-operative 4.79 to 41.42 mm post-operatively in the NLF group, BFP group from 6 to 39.42 mm and in the PMF group from 9.26 to 39.34 mm with p value=0.0001. NLF group showed complete and partial resolution of the burning sensation of the mouth at 93.75% and 6.25%, BFP at 62.25% and 32.75% while in PMF it was 68.5% and 31.25% respectively. One year postoperatively 3.28 mm increase in inter-commissure width was observed in the NLF group with a marginal increase in the PMF group and a negligible increase in the BFP group. 18.75% partial flap necrosis was seen in BFP, 18.75% in the PMF group, and 6.25% in the NFL group. Conclusion: All the flaps are efficacious in treating OSMF, however, NLF stands ahead with its higher reliability owing to its excellent blood supply.