Diagnosis and Management of oro-antral fistula: Case series and review

Azzouzi, Amar; Hallab, Lamiae; Chbicheb, Saliha

doi:10.1016/j.ijscr.2022.107436

Cited by 9 publications

(7 citation statements)

References 18 publications

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“…8 The procedure involves the design of a broadbased trapezoid mucoperiosteal flap, the release of the deepest portion of the flap using sharp dissection of the periosteum, and its placement over the defect followed by sutures. Azzouzi et al 16 reported a high success rate for the advanced buccal flap and they attributed it to the easy handling, the minimal donor site morbidity's, and the excellent blood supply of this simple flap. However, the Rehrmann flap may encounter limitations in the clinical practice, namely, the decrease of the buccal vestibule, and, sometimes, the failure of OAF closure.…”

Section: Discussionmentioning

confidence: 99%

Oroantral Communications: Clinical Efficacy of a Double-layered Technique With/Without the Palatal Connective Tissue Flap: A Superiority, Single-center, University-based Randomized Clinical Trial

Baldini

Giammarinaro

Cagidiaco

et al. 2023

Journal of Craniofacial Surgery

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The aim of this study was to compare the clinical results of combining a pedicle connective palatal flap coupled with the trapezoid buccal flap against the buccal flap alone in the closure of the oroantral fistula. Individuals with oroantral communication were consecutively included and eventually randomly allocated into 2 groups. In the group test, oroantral fistula was treated with the association of a buccal flap with a pedicle palatal connective tissue flap; in group control, a classic buccal sliding flap was performed. Patients' outcomes were recorded at 48 hours, 1 week, 2 weeks, and 1 month after surgery for assessment of primary (success rate) and secondary endpoints, such as experienced pain, discomfort, and complications. The success rate was 96.6% for the test group and 86.6% for the control group. No significant difference between the 2 groups could be observed regarding discomfort and pain. More pronounced pain was detected in the test group during the early healing period. This surgical procedure was demonstrated to be successful, with a high success rate and low patient discomfort.

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Section: Discussionmentioning

confidence: 99%

Oroantral Communications: Clinical Efficacy of a Double-layered Technique With/Without the Palatal Connective Tissue Flap: A Superiority, Single-center, University-based Randomized Clinical Trial

Baldini

Giammarinaro

Cagidiaco

et al. 2023

Journal of Craniofacial Surgery

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“…One article recommends using a double layer technique using septal cartilage for the bone defect and Bichat buccal fat pad with favourable results [ 16 ]. Other evaluations of the literature concluded that both treatment approaches are viable, with no relapses; however, present trials use small groups, and investigators recommend that larger groups be included in future trials for more reliable results [ 17 ]. The current study was carried out over a 7-year period, to assess the evolution, postoperative controls were carried out for removal of sutures and then every six months.…”

Section: Discussionmentioning

confidence: 99%

“…Considering all three flaps, the general conclusion of several studies is that the Bichat fat pad flap has the highest success rate [ 17 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Selecting the Best Surgical Treatment Methods in Oro-Antral Communications

Bereczki-Temistocle

Gurzu

Jung

et al. 2022

IJERPH

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Introduction: an oro-antral communication is defined as a permanent pathological connection between the maxillary sinus and the septic oral cavity. Several flaps can be used for the closure (buccal flap, palatal flap, combination techniques) but relapses occur often in case of a large defects and underlying general conditions. Bichat fad pad flap is a multipotent pedicled fatty tissue that is easily accessible from the oral cavity that can be used for the closure of medium-sized defects, even in immunocompromised patients due to its stem cell capacity. Materials and methods: the medical information of the patients diagnosed with oro-antral communications who were admitted and treated in the Oral and Maxillo-Facial Clinic Targu Mures, between 2013 and 2020 were analyzed. A database containing general information, reported causes, associated diseases, surgical methods used during admission, and relapses, was created. The information was statistically processed. The written consent and ethical approval were obtained. Results: the study shows that from a total of 140 cases, 72 were treated using buccal advancement flap, 49 using Bichat fat pad flap, and 19 using palatal flaps. The dimensions of the communications ranged between 0.3 cm and 1.5 cm. Several statistically significant results could be found when comparing the surgical methods. Of the 72 patients treated with buccal advancement flaps, 25 presented relapses as opposed to the patients treated with Bichat fat pad flaps who showed no complications, p < 0.05. Analysing this aspect further, all large defects (10 cases) ranging from 0.6 cm to 1.5 cm treated with advancement buccal flaps (Rehrmann flaps) showed relapses (p < 0.05). Considering the general conditions, out of 7 patients who received radiotherapy 4 presented relapses, as opposed to the healthy patients, p < 0.05. Regarding the reintervention for the relapsed cases, the majority of the cases treated a second time with buccal advancement flap (5 out of 7 cases) failed as opposed to the Bichat fat pad flap with no further relapses (p < 0.05). Conclusions: the most frequently used surgical treatment is the buccal flap, which also has the highest relapse rate. Both primary treatment with Bichat fat-pad flap and re-treatment of relapses using this flap have had 100% success rates, even in patients with general associated conditions, in contrast with patients treated by using the buccal flap. The dimensions of the oro-antral communication and general conditions are crucial factors for the success of the surgical treatment.

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“…Epistaxis, the passage of liquid or air via the OAC or OAF, discomfort throughout and around the infected sinus tract, voice changes, and wheezing when speaking are examples of acute symptoms. Chronic symptoms comprise diminished pain, free fluid drainage through the oral fistula, mucopurulent nasal discharge, the likelihood of later-stage detection of antral polyps through the defect, postnasal drip, unpleasant intraoral taste and odor, voice changes, and ear pain [ 6 ]. All maxillofacial surgeons face a daunting task in achieving complete and long-term closure of the OAF.…”

Section: Discussionmentioning

confidence: 99%

A Double Barrier Technique in Surgical Closure of Oroantral Communication

Pal¹,

Rao²,

Sanjenbam³

et al. 2022

Cureus

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Routine minor surgical procedures in the maxillary premolar or molar region often heal without any repercussions; however, some may culminate in an unintentional opening into the maxillary sinus, leading to the formation of oroantral communication. It is, therefore, imperative for a surgeon to recognize it and treat it sequentially to avoid long-term complications. This case report highlights a flapless double membrane closure of oroantral communication (OAC) with platelet-rich fibrin (PRF) and guided tissue regeneration (GTR) membranes and its edge over conventional methods.

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Diagnosis and Management of oro-antral fistula: Case series and review

Cited by 9 publications

References 18 publications

Oroantral Communications: Clinical Efficacy of a Double-layered Technique With/Without the Palatal Connective Tissue Flap: A Superiority, Single-center, University-based Randomized Clinical Trial

Oroantral Communications: Clinical Efficacy of a Double-layered Technique With/Without the Palatal Connective Tissue Flap: A Superiority, Single-center, University-based Randomized Clinical Trial

Selecting the Best Surgical Treatment Methods in Oro-Antral Communications

A Double Barrier Technique in Surgical Closure of Oroantral Communication

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