Defects after resection for a mixed tumor of the lesser salivary glands in the posterior palatal region are typical and most common indications for this procedure (Fig. 184.1B). Another indication for the procedure is an oroantral fistula produced in the posterior region of the alveolar process after exodontia. The average case can be closed easily with local flaps; however, bone loss may occur. If, in addition, soft tissues are traumatized and scarred and tissue loss has occurred, it can be very difficult to close the oroantral communication. In such cases, the buccal fat pad can be advantageously used.

Orthodontic surgery in the upper jaw is a further indication, especially in cleft palate patients, in whom an irregular dental arch necessitates displacement of the anterior part of the alveolar process, leaving the second or third molar in place. If advancement of the anterior fragment is necessary, a gap results. In this situation, the buccal fat pad is a great help in obtaining primary closure.