The use of Buccal fat pad free graft in regenerative treatment of peri-implantitis: A new and predictable technique.

INTRODUCTION: Peri-implantitis is a common condition, but no particular treatment protocol has shown to be definitively effective. Fat tissue in the oral cavity is widely available and easily accessed. The aim of the current study is to present a novel technique in the treatment of peri-implant lesions, utilizing a free fat tissue graft from the buccal fat pad (BFP).

PATIENTS AND METHODS: Free fat graft (FFG) was harvested from the BFP in eight patients and used with bone substitutes to regenerate 22 peri-implant lesions. Mechanical debridement of the implants surface and the granulation tissue were made with curettes or with Er: YAG laser. Clinical parameters such as plaque index, bleeding on probing, pocket depth, gingival recession, and the clinical attachment level were recorded as a baseline during the follow-up period. In addition, radiological evaluation was made preoperative during the follow-up period.

RESULTS: The donor site of the free fat graft was healed without cosmetic defect in all patients. Twenty-two peri-implant lesions were followed up for 12 months. Bleeding on probing and the pocket depth were significantly improved, and the clinical attachment level was achieved and maintained during the follow-up period due to the fibrous healing of the free fat graft. Satisfactory esthetic and functional outcomes of the treated implants were achieved and maintained.

CONCLUSIONS: Free buccal fat graft heals by fibrosis. The fibrotic tissue adheres strongly to the implant surface and with stand the recurrence of the peri-implant lesion and provides stable and predictable outcome.