Closure of oro-antral fistula with pedicled buccal fat pad. A case report and review of literature

Abstract

SummaryObjectives: Chronic oro-antral fistula following dental extraction is not uncommon. Application of pedicled buccal fat pad (BFP) in the repair of the fistula is rather uncommon in our environment. This article demonstrates the use of BFP in the repair of chronic oro-antral fistula. Methods: A case of a chronic oro-antral fistula of 5-year duration in a 56-year old man successfully repaired with pedicled buccal fat pad after unsuccessful several attempts with other local flaps is presented. A review of relevant literature using MEDLINE is also presented. Results: Complete epithelization of the pedicled BFP was observed after 4 weeks with no postoperative complication. Conclusion: Pedicled buccal fat pad is a reliable flap for the repair of oro-antral fistula. The easy mobilization of the BFP and its excellent blood supply and minimal donor site morbidity makes it an ideal flap. It should also be considered as a reliable back-up procedure in the event of failure of other techniques.

Evaluation of Versatility and Effectiveness of Pedicled Buccal Fat Pad Used in the Reconstruction of Intra Oral Defects

“…Granizo et al have stated that the closure of larger defects cannot be guaranteed without producing flap necrosis or creating a new fistula [6]. The buccal fat pad is an encapsulated, rounded, biconvex specialized fatty tissue, which is distinct from subcutaneous fat [16]. Buccal fat pad was considered a surgical nuisance for many years because of its accidental encounter during various operations in the pterygo mandibular area such as tumor, orthognathic, or trauma surgeries [15][16][17].…”

“…Pedicled buccal fat pad has also been employed in the closure of surgical defects following tumor excision [7,16], excision of leukoplakia and sub mucous fibrosis [16,18], as well as closure of primary and secondary palatal clefts [5,19].…”

Management of idiopathic alveolar bone necrosis associated with oroantral fistula after upper left first molar extraction

“…4,6,12 If the oroantral communication is maintained open to the oral cavity for more than 48 hours or if there is infection, chronic inflammation of the sinus membrane and permanent epithelization of the fistula will increase the risk of sinusitis. 5 Management of oroantral fistula closure consists of nonsurgical and surgical management. If fistulas are small (less than 5 mm) and sinusitis is absent or eliminated, spontanues healing may occur.…”

“…3,4 Frequently occur because of iatrogenic oroantral communication after tooth extraction, infection, inflammation, cyst, neoplasma, and trauma. [4][5][6] The most common cause of oroantral fistula is tooth extraction, mostly from extraction of upper lateral teeth or teeth posterior to the maxillary canines. 3,7 Oroantral fistula formed from communication between oral cavity and maxillary sinus, which do not healed by means of blood clot, and there is granulation tissue formation and migration of gingival epithelial cells that partially grow into the canal.…”

Fechamento De Fístula Bucoantral: Relato De Caso Clínico

“…Esta é definida como uma comunicação patológica, circundada por tecido epitelial, entre a cavidade bucal e seio maxilar, classificada em alvéolo-sinusal, palato-sinusal e vestíbulo-sinusal 3,4,5 . A causa mais comum é em decorrência da extração de dentes posteriores (92,63%), pela estreita relação anatômica entre os ápices desses dentes com o assoalho do seio maxilar, podendo ocorrer com menor frequência por traumas (1,3%), infecções e neoplasias (4,47%), sobretudo, as neoplasias ocorrem com mais prevalência no seio maxilar, comparado com os outros seios paranasais 6,7,8,9,10 .…”