Interrelated buccal fat pad with facial buccal branches and parotid duct

The facial nerve branches are vulnerable during manipulation of the buccal fat pad. The aim of this study is to describe the precise anatomical interrelation among the buccal fat pad, buccal branches of the facial nerve, and parotid duct. Nineteen hemifaces of Korean cadavers (11 male and 8 female) fixed in 10% formaldehyde solution were dissected. An average 3.6 buccal branches of the facial nerve were found. The facial buccal branches and parotid duct crossed each other within a semicircle with a 30-mm radius. The base (diameter) is parallel to a horizontal line passing the corner of the mouth and 12 mm above. Its center is located 53 mm lateral to it. The buccal branches of the facial nerve have two locations at the buccal fat pad: Type I, branches crossing superficial to the buccal fat pad in 14 of 19 (73.7%) specimens; and Type II, two twigs passing through buccal extension of the buccal fat pad in 5 of 19 (26.3%). An interrelation of parotid duct and buccal fat pad is as follows: parotid duct crossing superficial to the buccal extension of buccal fat pad in 8 of 19 (42.1%) specimens, crossing deep to the buccal extension of buccal fat pad in 5 of 19 (26.3%) specimens and crossing along the superior border of the buccal extension of buccal fat pad in 6 of 19 (31.6%) specimens. There is a 26.3% chance of injury to the buccal branch during total removal of buccal fat pad. The parotid duct runs deep to the buccal extension of buccal fat pad in 26.3% of cases.     

Oroantral fistula: broad-contact closure

1. A modified Rehrmann's buccal advancement flap technique is described for the treatment of medium-sized oroantral fistulae. 2. Its advantages are listed. 3. Disadvantages are: a slightly longer operating time, and because of the longer movement of the buccal flap the buccal sulcus temporarily is shallower than the traditional buccal flap technique. 4. The buccal sulcus however, is reconstituted after a period of two months.     

Buccal corridors and smile esthetics.

PURPOSE: The purpose of this study was to determine the influence of buccal corridors on smile attractiveness when judged by lay persons. Material: Full-face color slides of 10 randomly selected smiling subjects (5 women, 5 men) were digitized. The maxillary posterior dentitions for all subjects were digitally altered to produce a range of smile fullness: narrow (28% buccal corridor), medium-narrow (22% buccal corridor), medium (15% buccal corridor), medium-broad (10% buccal corridor), and broad (2% buccal corridor). The 5 images of each subject were paired into 11 possible combinations, and the resulting 110 pairings were randomly projected to a panel of 30 adult lay persons who compared the 2 images in each pair for smile attractiveness. Results: Statistical analysis with the Wilcoxon signed-rank and rank-sum tests showed that (1) a broader smile (minimal buccal corridor) was judged by lay persons to be more attractive than a narrow smile (larger buccal corridors), and (2) no significant differences were found in judging between male and female subjects or between male and female judges. Conclusions: Having minimal buccal corridors is a preferred esthetic feature in both men and women, and large buccal corridors should be included in the problem list during orthodontic diagnosis and treatment planning.     

Evaluation of different treatment modalities for closure of oro-antral communications and formulation of a rational approach

Oro-antral communication is a common occurrence following removal of maxillary premolars and molars because of anatomic proximity of root apices of these teeth and maxillary antrum. Various methods have been described in literature for closure of these communications which vary from simple local methods like buccal advancement flap to complex distal flaps and grafts. Out of these plethora of the treatment modalities available for the treatment of oro antral fistula, the most simple and commonly used ones are either the buccal flap or the buccal pad of fat. In our study we compared the results, advantages and disadvantages of using buccal advancement technique and buccal fat pad individually and also in combination. With this paper, we aim to shed light on the efficacy of buccal pad of fat and the buccal flap, either alone or together, for the closure of OAF of various regions. We also aim to provide a systematic and rational approach for repair of oro-antral communications.     

Traumatic pseudolipoma: herniation of buccal fat pad,a report of two cases

Traumatic pseudolipoma is a term used to describe intra-oral herniation of the buccal fat pad. A tear of the buccinator muscle and buccal mucosa allows the buccal fat pad to extrude into the oral cavity. Initially, the lesion can suggest a more sinister cause, but a history of trauma, an absence of mass before the accident, anatomical site and fatty appearance should suggest a diagnosis of traumatic herniation of buccal fat pad. This injury is rare, but two cases presented to the authors’ hospital over a period of 3 months.     

粘接型颊面管替代磨牙带环的初步研究

目的研究粘接型颊面管代替磨牙带环的可行性。方法选取因牙周病拔除的第一恒磨牙30颗,分为3组,按临床操作程序粘接颊面管,在粘接5 min、30 min和24 h后分别测量粘接型颊面管的粘接强度;统计正畸患者中粘接型颊面管和带环的脱落率,并进行统计分析。结果粘接24h后粘接型颊面管的抗剪切强度为(14.11±0.41)MPa,抗张强度为(3.04±0.11)MPa。粘接型颊面管和磨牙带环的脱落率相同。结论在多数情况下,粘接型颊面管都可替代磨牙带环。     

带蒂颊脂垫瓣在口腔内软组织缺损修复中的应用

目的:探讨带蒂颊脂垫组织瓣在邻近口腔软组织缺损的修复中的应用。方法:11例口腔内软组织缺损修复患者,在分离颊脂垫瓣后,植入邻近软组织缺损进行组织修复。结果:本组病例中,颊脂垫瓣全部成活,3个月后全部黏膜化。结论:颊脂垫组织瓣血运丰富、操作方法简单、损伤小、成活率高,是修复其邻近软组织缺损的一种治疗方法。     

颊脂垫及其在口腔临床中应用研究进展

颊脂垫是一块位于颊部深层间隙、具有完整包膜的脂肪三角体,也是口腔颌面部解剖中相对容易获取的脂肪组织块。它是一种特殊类型的脂肪组织,具有填充、保护、滑动和缓冲的作用。尽管距离“颊脂垫”的首次描述已经过去200多年,但是外科医生们对其研究从未停止。目前,颊脂垫已普遍应用于口腔软组织缺损的修复,如黏膜缺损、口腔上颌窦瘘、慢性颊瘘、腭裂等,并且取得了令人满意的结果。有关颊脂垫的研究和新的运用也越来越多。文章就颊脂垫及其在口腔临床中应用研究进展做一综述。     

“夹心植骨”预防骨劈开术后唇颊侧骨壁吸收的临床研

研究背景：当牙槽嵴尤其是上颌前牙区牙槽嵴宽度不足时,采用骨劈开同期种植体植术能获得可靠地临床效果。然而许多研究和作者本人的临床观察均发现,采用该手术后常见种植体唇侧骨壁部分吸收,致种植体唇侧上、中部多个螺纹暴露于骨面,其表面仅有软组织覆盖,当患者的附着龈较薄时甚至会透出种植体的颜色,这种状况无疑将对种植义齿的长期美观效果和寿命产生严重的不利影响。研究目的：评价＂夹心植骨＂法防止骨劈开后唇颊侧骨壁吸收的临床效果。方法：36例上颌前牙缺失区牙槽嵴宽度2～4mm,有足够骨高度患者,采用骨劈开术同期植入种植体,共植入植体40枚,其中16枚种植体唇侧骨瓣较稳固,可与种植体紧密相贴,直接采用颗粒骨移植材料（天博骨粉或Bio-Oss）和胶原膜覆盖（海奥修复膜或Bioguide膜）,作为对照组。将24枚种植体唇侧骨瓣撑开,在种植体唇侧面与骨瓣之间形成1mm左右的间隙,间隙内填入颗粒骨移植材料（天博骨粉或Bio-Oss）,使种植体唇侧骨质总厚度大于1mm,覆盖胶原膜（海奥修复膜或Bioguide膜）,无张缝合创口。6个月后行Ⅱ期手术,翻瓣检查种植体唇侧骨质状况和骨壁厚度。结果：对照组16枚种植体唇侧骨壁均有不同程度吸收,种植体上部有3～5个螺纹暴露于骨面;24颗采用夹心植骨的种植体唇侧均有坚实的骨质,未见骨吸收和螺纹暴露,种植体唇侧骨壁厚度均大于1mm。结论：骨劈开术中在唇颊侧骨瓣和种植体表面之间夹心植入颗粒状骨移植材料,能有效地防止唇侧骨壁吸收,保证种植体唇侧有足够厚度完整的骨质覆盖。     

Buccal attachment loss in Swedish adolescents.

A case referent study was performed to identify factors connected with loss of buccal attachment in adolescents. The study group was identified among 18-year-olds who had participated 2 years earlier in a study of periodontal conditions in adolescents. The criterion for inclusion in the case group was buccal attachment loss (greater than or equal to 1 mm) in one or more sites. Information on 28 variables, identified earlier as being related to recessions, was collected in a clinical examination, interview and observation. The referent group consisted of 66 subjects and the case group of 71 subjects. The case group comprised 2 subgroups, one identified as having buccal attachment loss in 1987 and the other with attachment loss occurring in the years 1987-89. Statistical analyses, using the chi 2 test, logistic regression and a variance component model, were performed to detect factors related to buccal attachment loss. These factors were thin alveolar tissue, narrow width of the attached gingiva and presence of teeth with buccal displacement. The results indicate that the anatomy of the buccal alveolar process is related to the presence of buccal attachment loss in populations with a high level of oral hygiene. To evaluate the importance of possible risk factors or etiological factors for development of buccal loss of tooth support, prospective epidemiological or experimental studies are needed.     

第二磨牙锁He与牙弓后部拥挤

目的选择第二磨牙锁的成年患者,通过对其Ｘ线头颅侧位片的测量,与正常进行比较,对第二磨牙锁的病因做初步分析,为今后的临床治疗工作提供参考。方法分别测量正常和后牙锁患者的头颅侧位片,测量上颌第一磨牙远中最突点在颅底平面的投影和翼上颌裂点在前颅底平面的投影两者之间的距离,测量数据进行ｔ检验。结果第二磨牙锁患者上颌第一磨牙到上颌骨后壁的距离明显小于正常。结论第二磨牙锁与后部牙弓间隙不足密切相关,分析牙列拥挤度时,还应考虑后牙段间隙问题,尤其是推磨牙向后的病例,如果预测后牙段有拥挤的可能,应尽早拔除第三磨牙。     

颊脂垫移植的组织学实验研究

目的　为了解无覆盖带蒂颊脂垫组织瓣修复口腔软组织缺损愈合过程中组织学的变化。方法　人为造成缺损区 ,用无覆盖带蒂颊脂垫移植修复口腔内组织缺损 ,观察 10周。结果　发现颊脂垫口腔面 6～ 8周完全上皮化 ;脂肪组织逐步被纤维组织取代。再生的粘膜呈粉红色 ,类似于正常的口腔粘膜 ,5 0 %的实验动物愈合后粘膜存在轻度瘢痕。结论　该组织瓣解剖恒定 ,易获取 ,供区与受区近 ,可在同一切口内完成 ,供区隐蔽 ,不影响外观及功能。此方法为修复口腔软组织缺损提供了一种新方法     

A comparative light-microscopic, electron-microscopic and chemical study of human vaginal and buccal epithelium

The scarcity of sizeable specimens of normal oral mucosa for experimental purposes has hampered research on oral epithelium. Because large specimens of viable human vaginal mucosa are readily available and because vaginal and buccal epithelia are microscopically similar, vaginal mucosa has been used successfully to establish a human cyst model in experimental animals. The ultrastructure and distribution of keratin filaments in these epithelia are also similar, as is their permeability to water and a number of chemical substances. Therefore, if vaginal mucosa could be substituted for buccal mucosa it would expedite research on the epithelium of buccal mucosa. To strengthen further the concept that vaginal epithelium could replace buccal epithelium in certain experimental studies, the thickness of these epithelia, their patterns of surface keratinization, the presence or absence of intercellular lipid lamellae and their lipid contents were now compared. Thirty-three specimens of vaginal mucosa from postmenopausal women and 36 of buccal mucosa were investigated. To compare the thickness of the epithelial layers the number of cell layers in sections of 20 vaginal and 20 buccal mucosal specimens were counted in the three thickest and three thinnest regions of each specimen. Surface keratinization was evaluated on sections stained with the Picro-Mallory method. To demonstrate lipid lamellae two vaginal and two buccal mucosa specimens were examined electron microscopically after normal fixation and postfixation in ruthenium tetroxide. Following solvent extraction of 11 vaginal and 14 buccal epithelia, quantitative lipid analyses were performed using thin-layer chromatography. No statistically significant differences were found between the maximum and minimum number of epithelial cell layers. The patterns of surface keratinization and the distribution and appearance of the lipid lamellae in the intercellular spaces were similar. The lipid composition of the two epithelia corresponded, except for the cholesterol esters and glycosylceramides, which were higher in buccal epithelium. Ceramides for vaginal epithelium and triglycerides for buccal epithelium were not determined. Based on structural similarities, a similar lipid composition and earlier findings, it is concluded that vaginal epithelium can be used as a substitute for buccal epithelium in certain in vitro, and possibly for in vivo, studies.     

伴放线放线杆菌在龈下菌斑和颊黏膜分布研究

目的:比较伴放线放线杆菌(actinobac illus actinomycetem com itans,A.a)在不同类型牙周炎患者龈下菌斑和颊黏膜中的分布。方法:通过聚合酶链反应(polym erase chain reaction,PCR)对侵袭性牙周炎患者(AgP)、慢性牙周炎患者(CP)、牙周健康者口腔龈下菌斑和颊黏膜中的A.a进行检测,分析该菌分别在两部位的相对含量。结果:AgP组菌斑和颊黏膜样本中A.a阳性检出率均为41.7%,分别高于CP组(菌斑16.7%、颊黏膜10.0%)和牙周健康组(菌斑和颊黏膜均为0%)。AgP组A.a在菌斑和颊黏膜的相对含量分别为38.5%和22.2%,高于CP组(菌斑19%、颊黏膜12.75%)。结论:A.a不仅存在于龈下菌斑中,也能够粘附于颊黏膜;A.a是AgP的主要优势菌也参与了CP的菌群组成。     

Dimensional changes of the ridge contour after socket preservation and buccal overbuilding: an animal study

Objectives: The aim of the study was to volumetrically assess alterations of the ridge contour after socket preservation and buccal overbuilding.
Material and Methods: In five beagle dogs, four extraction sites were subjected to one of the following treatments:
Tx 1 : The socket was filled with BioOss Collagen^® and covered with a free gingival autograft from the palate (SP).
Tx 2 : The buccal bone plate was forced into a buccal direction using a manual bone spreader and SP was performed.
Tx 3 : The buccal bone plate was forced into a buccal direction using a manual bone spreader; SP was performed.
Tx 4 : The socket was filled with BioOss Collagen and a combined free gingival/connective tissue graft was used to cover the socket and for buccal tissue augmentation.
Impressions were obtained at baseline, 2 weeks and 4 months post-operatively. Casts were optically scanned and superimposed in one common coordinate system. Using digital image analysis, the volumetric differences per area among the different treatment time points and among the treatment groups were calculated.
Results: Four months after tooth extraction, no statistically significant differences with regard to the buccal volume per area could be assessed among the treatment groups.
Conclusion: Overbuilding the buccal aspect in combination with socket preservation is not a suitable technique to compensate for the alterations after tooth extraction.     

核转录因子-κB在金地鼠颊囊癌变过程中的表达研究

目的　探讨核转录因子-κB家族成员的重要亚基p65及其抑制蛋白IκBα在金地鼠颊囊鳞癌发生过程中的 表达及意义。方法　建立金地鼠颊囊癌变的动物模型,采用Western blot法检测金地鼠正常颊黏膜、上皮单纯增生 黏膜、上皮异常增生黏膜和鳞癌组织所提取的核蛋白中p65的表达差异;采用SABC免疫组织化学法检测在金地鼠 颊黏膜正常上皮、上皮单纯增生、上皮异常增生、鳞状细胞癌中IκBα的表达变化。结果　正常黏膜和上皮单纯增生 黏膜中,p65表达很弱,但普遍存在IκBα的表达,该表达多局限于黏膜基底层和棘层底部细胞的胞浆中。随着上皮 异常增生的出现,p65表达增强,与正常黏膜和单纯增生黏膜相比有统计学意义(P<0.01),而IκBα表达则显著下 降(P<0.05)。鳞癌组织中p65的表达显著高于正常黏膜和异常增生黏膜(P<0.01),IκBα的表达显著升高,明显 高于上皮异常增生黏膜(P<0.01),甚至超过正常水平(P<0.01)。结论　p65在金地鼠颊囊鳞癌发生、发展过程中 被激活。p65和IκBα在金地鼠颊囊癌变过程中的表达异常,上皮异常增生阶段p65的表达上调而IκBα的表达下调, 可能是口腔黏膜上皮癌变过程中的早期事件,可作为口腔早期癌变监测的生物学指标。     

Effect of a Connective Tissue Graft in Combination With a Single Flap Approach in the Regenerative Treatment of Intraosseous Defects

Background: In the attempt to limit the post‐surgery increase in buccal gingival recession (bREC), effect of a connective tissue graft (CTG) when combined with a buccal single flap approach (SFA) in the regenerative treatment of intraosseous defects is evaluated. Methods: Data related to 30 patients with an intraosseous defect treated with a buccal SFA with (SFA+CTG group; n = 15) or without (SFA group; n = 15) placement of a CTG and regenerative treatment were retrospectively derived at three clinical centers. bREC and probing parameters were assessed at presurgery and 6 months post‐surgery. Results: In addition to a significant attachment gain and probing depth reduction, adjunctive use of a CTG to a buccal SFA in the regenerative treatment of periodontal intraosseous defects associated with a buccal bone dehiscence resulted in a limited post‐surgery bREC, a lower prevalence of defects with a clinically detectable apical displacement of the gingival margin, and an increase in gingival width and thickness. Conclusion: Adjunctive use of a CTG in the regenerative treatment of intraosseous defects associated with buccal bone dehiscence accessed by buccal SFA may support the stability of the gingival profile.     

颊侧径路在下颌水平阻生第三磨牙拔除术中的临床应用

目的 探讨颊侧径路在拔除下颌水平阻生第三磨牙术中的临床应用效果.方法 对57例患者的57颗下颌中、低位水平阻生的第三磨牙作颊侧径路的拔除术.对患者拔牙术后疼痛、术后开口度和创口情况等进行客观评估.结果 1)57例患者的57颗下颌中、低位水平阻生牙全部顺利完整拔除;2)颊侧径路去骨充分、术野大、暴露清晰、截冠便捷;3)颊侧径路并发症少.结论 颊侧径路适用于下颌中、低位水平阻生第三磨牙的拔除.     

Incidence of candidiasis of the buccal mucosa and efficiency of its treatment in diabetics

A total of 102 patients with diabetes mellitus (types 1 and 2) were examined. Local immunity of the oral cavity and infection of the buccal mucosa with Candida fungi was evaluated. The incidence of true candidiasis of the buccal mucosa in diabetics was 35.3% and of latent candidiasis 43.1%. The adsorption activity of epithelial cells of the buccal mucosa was decreased in diabetics. Treatment was prescribed for all patients with both true and latent infection. Basic therapy did not essentially modify the course of candidal infection of the buccal mucosa, while therapy with Varzi-Yatchi mineral water 4.5 times decreased the contamination of the buccal mucosa and increased the adsorption activity of epithelial cells of the buccal mucosa.     

LncRNA H19与OSF发生及癌变的关系

目的:探讨lncRNA H19在口腔黏膜下纤维性变(OSF)发生及癌变过程中的表达变化及其意义.方法:实时荧光定量PCR技术分别检测12例正常颊黏膜组织、33例OSF颊黏膜组织、31例伴OSF颊癌组织中的LncRNA H19的表达水平.结果:LncRNA H19在颊黏膜组织、OSF颊黏膜组织、伴OSF颊癌组织中的相对表达量分别为1.17±0.37、3.44±1.08、8.88±1.78,组间两两之间比较,P＜0.01.结论:LncRNA H19可能参与OSF的发生及癌变.