| Buccal fat pad (BFP) is important in the oral cavity and is of special clinical importance. However, this mass of specialized fatty tissue was not widely clinically applied until recently. The healing process of BFP as an uncovered fat pad is unusual. For the pedicled graft, the anatomic region is consistent, there is good vascularization and ease of access, there is proximity between the donor site and the recipient site, and the donor site is concealed; surgery has no influence on appearance or function. Scientists and clinicians are unable to study the detailed histological changes in clinic. The aim of this paper is to report on the use of the BFP pedicled graft in the reconstruction of oral defects, and to give a report on histological changes during the healing process, based on animal experiments; possible clinical applications will be discussed.On the basis of cadaveric dissection, we observe the size, shapeand blood supply of buccal fat pad, providing morphology basic for its design of clinical application. Furthermore, on the basis of animal experiment, we observe the histological changes and the whole healing process of the buccal fat pad as an uncovered pedicled graft for reconstruction the defects.The pedicled buccal fat pad graft is that anatomical region is consistent, good vascularization, ease of access, proximity of the donor site to the recipient site, the donor is concealed, and surgery has no influence on appearance and function. Buccal fat pad is an ideal filling material for reconstruction defects in oral cavity. Epithelial grow faster by 1-2 weeks using the buccal fat pad than other flaps to repair intraoral defects. It takes about 4~6 weeks to form complete epithelial. There was difference between reconstructive mucosa and normal buccal mucosa in histology. We studied the origin of epithelium, transition from surrounding normal epithelium is an important cause by series sections, but can't rule out cells implantation.Now, lots of studies certified that fat cells actively secrete many members of the cytokine family. Many researches have done on growth factors and reconstruction; however, the relation of fat cells and cytokines hasn't been reported. In our research work, we study the expression of EGFR and TGFfl in the process of buccal fat pad as an uncovered pedicled graft.Part I Anatomical observation of the buccal fat padOur findings are based on 10(6men, 4 female) cadaver dissections and two vascular casting. The buccal fat pad, consisting one body and four extensions (buccal, pterygoid, pterygopalatal, temporal), is situated in buccal space, infratemporal space, and pterygomandibular space and pterygopalatal fossa. The buccal fat pad is enclosed by a thin and transparent membrane and connected loosely with the surrounding tissues. Buccal fat pad has several resources providing for blood supply. The minor branches are from surrounding masster and temporalis, the major arterial blood supply is buccal and deep temporal branches of the maxillary artery, the branches of facial artery.Providing the morphology bases for designing of clinical application, we observed the size, shape and blood supply of the buccal fat pad. The ideal portions (the main body, buccal extension pterygoid extension and the anterior of temporal extension) can be used in clinical application. Their altogether volume is 6.8 cm X 3.8cm X 0.6cm. The posterior of temporal extension and ptergopalatal extensions cannot be used because they are deep and small volume.Part II Gross and histological observation of the buccal fat pad asan uncovered pedicled graft28 adult rabbits, mean weights from 2.5kg to 3.0kg, were used in this study; 14 rabbits comprised the experimental groups, F/M=1:1. These 14 rabbits were randomly divided into 7 groups, F/M=1:1.The remaining 14 rabbits were used as control groups. In each group, an area of 1.5*1.5cm at buccal mucosa was surgically excised; the area was then covered by uncovered BFP. The surgically exposed areas in the control gr...
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