Evaluation of different treatment modalities for closure of oro-antral communications and formulation of a rational approach

Abstract

Oro-antral communication is a common occurrence following removal of maxillary premolars and molars because of anatomic proximity of root apices of these teeth and maxillary antrum. Various methods have been described in literature for closure of these communications which vary from simple local methods like buccal advancement flap to complex distal flaps and grafts. Out of these plethora of the treatment modalities available for the treatment of oro antral fistula, the most simple and commonly used ones are either the buccal flap or the buccal pad of fat. In our study we compared the results, advantages and disadvantages of using buccal advancement technique and buccal fat pad individually and also in combination. With this paper, we aim to shed light on the efficacy of buccal pad of fat and the buccal flap, either alone or together, for the closure of OAF of various regions. We also aim to provide a systematic and rational approach for repair of oro-antral communications.

Pedicled buccal fat pad in the management of oroantral fistula: a clinical study of 15 cases

“…9,11,18 In the authors' opinion, defects larger than 5 cm  1 cm can be managed better using BFP and buccal advancement flap. It provides more stability, tension free closure, can be used to cover BFP and provides additional tissue for closure where there is deficient BFP.…”

“…Therefore, it is commonly referred to as the boule de Bichat or bolle graisseusse in French; it is called wangenfettpfropf or Wangenfettpolster (Wangen = Cheek + -fett = fat, polster = pad-cheek, fat, pad) in German, and the sucking pad, sucking cushion, masticatory fat pad, or buccal pad of fat in English. 18 The BFP is a simple lobulated mass consisting of a central body and four extensions: buccal, pterygoid, pterygopalatine, and temporal (Fig. 1).…”

The Versatility in the Use of Buccal Fat Pad in the Closure of Oro-antral Fistulas

“…The BFP structure can be used in the correction of several oral defects, such as fistulas and OAC; in reconstruction after tumor resection; in rehabilitation of cleft patients; in aesthetic corrections of the face; and in implant-graft coating [7]. The scope of defects that can be treated using the pedicled BFP flap varies according to the patient's morphology, as this structure varies in dimension from one individual to another [8].…”

The impact of acute post-extraction oroantral communications surgical treatment on patients' quality of life in early post-operative period

“…The acute post-extraction oroantral communication is one of the most common complications which occur in the course of upper molars extraction [10]. Commonly accepted methods of such conditions treatment as a vestibular flap, palatal flap or a Bichat's fat pad etc., involve local tissues, which inevitably leads to additional surgical trauma.…”