Adele scattarella 1, andrea ballini 1, felice roberto grassi 1, andrea carbonara 1, francesco ciccolella 1, angela dituri 1, gianna maria nardi 2, stefania cantore 1, francesco pettini 1. Closure of oroantral fistula with buccal fat pad flap and. Sterken en volgens besluit van het college voor promoties. Jun 01, 2012 treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants. The treatment proposed to the patient was closure of the oroantral fistula using palatine flap. Istanbul university, faculty of dentistry, department of oral and maxillofacial surgery, capaistanbul, turkey accepted 30 march 2011. A 6monthsurgical treatment of oroantral fistula, after a tooth removal, using the buccal. Pdf decisionmaking in closure of oroantral communication and. Mar 29, 2016 ubc medicine neurology clinical skills motor, sensory, and reflex examination duration. Meticulous planning is employed to maximize the successful closure of an oroantral fistula. Pdf closure of oroantral fistula by using buccal fat pad.
The data records included patient age, gender, etiology, size, location, duration, and the method of surgical treatment. The clinical practice most frequently involves the monolayer technique of closing an oroantral defect developed. The closure of oroantral fistula can yet be done through the use of monocortical bone grafts or tooth transplant. The patient was informed about the aims and methods of the study and written consent was. The main goal of the clinician in the management of oac fistula is the closure of the defect and prevention of oral bacteria and food debris penetrating the sinus. We recovered the oroantral communication using the sliding flap, without suture in both plans figures 3b and 3c. Surgical closure with flap techniques factors that determine surgical technique. The oroantral fistula is a pathological connection between the maxillary sinus and with the. Click here to learn more about closure of an oroantral fistula, sinus surgery, and postoperative instructions for an oroantral fistula. Removal of maxillary molars may occasionally results in oro antral communication. Alternative method to treat oroantral communication and.
The creation of an oac is most commonly due to the extraction of a maxillary upper tooth typically a maxillary first molar closely related to the antral floor floor of the maxillary sinus. Dona bhattacharya surgical anatomy of maxillary sinus note on oaf contents. In the setting of an active sinus infection, concurrent sinus surgery will reduce the risk of recurrence. In cases of healthy antrum and small fistula, closure is usually spontaneous. May 31, 2012 closure of an oral antral opening using preshaped collagen membrane. Closure of oro antral fistula by using a membrane youtube. It may be the result of different pathological processes and often occurs following an extraction. Alternative surgical management of oroantral fistula using. Repair oroantral fistula otolaryngology coding ask an expert. We present a technique in which nasoseptal cartilage graft is used for the closure of the oroantral communication. Oct 01, 2010 buccal advancement flap is a simple and easy to master technique to close oroantral fistula. Mar 19, 20 oroantral communication oroantral fistula oroantral communication oac is an abnormal communication between the maxillary sinus and the oral cavity. Closure of oroantral fistula by using buccal fat pad or buccal advancement flap. Isler sc, demircan s, cansiz e 2011 closure of oroantral fistula using auricular cartilage.
Through the fistula itself, a marked amount of thickened mucosa was stripped out and removed. Repair oroantral fistula otolaryngology coding ask an. Summary closure of oroantral fistula may often be a difficult problem presenting a chal lenge to the oral surgeon. Closure of an oral antral opening using preshaped collagen. Data recorded were patient age and sex, cause of fistula, signs and symptoms, interval from appearance of fistula to repair, fistula size, radiographic appearance, method of repair, and immediate and late complications. C absorbable 40 catgut suture on the right maxillary sinus mucosa. In general, most patients will have spontaneous closure of a small oroantral fistula oroantral fistula oaf is an epithelialised oroantral communication oac. The maxillary sinus takes up a large part of the body. The term oroantral fistula is meant to indicate a canal lined by epithelium that may be filled by granulation tissue or by polyposis of the sinus membrane, most frequently due to iatrogenic oroantral communication. University of groningen biodegradable polyurethane for. Last updated may 31, 2012 10 comments on occasion, i will have referred to my office, cases where a 1st or 2nd molar have been extracted leaving a large opening into the maxillary sinus. Decisionmaking in closure of oroantral communication and.
Oroantral communication closure using a pedicled buccal. Recent studies revealed that an oroantral fistula should be closed within. Postoperatively, the orally exposed fat gradually was. Bos, dmd, phd an oroantral communication oac is an open connection between the oral cavity and maxillary sinus.
B circular incision around the fistula and mucosa displacement on the fistulous path. The bony fragment itself was then debrided back to healthy bleeding tissue. A fistula latin a pipe or tube is an abnormal communication between the lumen or surface of one organ and the lumen or surface of another or between vessels. Without treatment, fistula often leads to chronic oafs, which usually. Saleh bakry assistant professor of oral and maxillofacial surgery 2. It is the intention of this article to discuss the problems in the treatment of oroantral fistulas and to represent an operation for their closure that has not received the recognition it deserves. The closure of an oroantral communication of any origin, can be achieved by different techniques. Surgical anatomy of maxillary sinus note on oroantral. Closure of oroantral communications using a pedicled.
Treatment of oroantral fistula jama otolaryngologyhead. Various techniques have been examined for the closure of oroantral communications. Closure of oroantral fistula through a combined use of buccal fat pad and buccal advancement flap is a safe and reliable method, with few complications and provides an adequate barrier to withstand a mild degree of sinus inflammation which is invariably present in the setting of an oroantral fistula. Combined palatal and buccal flaps in oroantral fistula repair. Surgery practice is oroantral fistula, a pathological pathway between the. Oroantral fistula repair with different surgical methods. Surgical options in oroantral fistula treatment fulltext. Surgical anatomy of maxillary sinus note on oroantral fistula.
However in large defects surgical closure is required. A rotational flap of the buccal mucosa was then elevated with the bovieelectrocautery device. While approximately two thirds of the lesions are in the mandible, one third is located in the maxilla. Note the opacification of the maxillary sinus, indicating chronic infection. Caldwellluc approach to locate maxillary third molar root piece fig. The risks of a closure of an oroantral fistula may include. A coronal ct scan of the sinuses, showed a defect in the floor of the left maxillary antrum, corresponding to the oroantral fistula. Many authors have described various surgical techniques, starting with durham in 1893 who advocated vascularised soft tissue pedicle flap for closure of these defects. The present study was conducted to compare the clinical outcomes of buccal fat pad flap or buccal advancement flap in closure of the oroantral fistula. The oroantral fistula oaf develops if the oac remains open and becomes. Pdf after removal of a dental implant or extraction of a tooth in the upper jaw, the closure of an oroantral fistula oaf or oroantral communication. Visscher, md, baucke van minnen, dds, md, phd, and rudolf r. The same experienced surgeon recorded the size and location of all cases. The management of bisphosphonate related necrosis of the jaw has become clinical routine.
Oaf could be caused by dental infection, osteomyelitis, radiation therapy, trauma or following removal of maxillary cysts or tumors. Treatment of oroantral fistula with autologous bone graft and application of a nonreabsorbable membrane. Treatment of oroantral fistula acta stomat croat 2002. We recovered the oroantral communication using the sliding flap, without suture in. This retrospective study evaluates the success of three different surgical techniques of oaf repair.
Oroantral fistula oaf is a pathologic communication between the oral cavity and. Ubc medicine educational media recommended for you. Various surgical options pulkit khandelwal 1, neha hajira 2 abstract 2ur dqwudofrppxqlfdwlrqdqg. An oro antral fistula oaf creates a passage for oral microbes into maxillary sinus with numerous possible complications.
This report evaluates the use of a pedicled buccal fat pad graft for closure of oroantral fistulae. Its treatment involves removal of the oroantral fistula, surgery of the maxillary sinus and closure of the oroantral defect 1,2,5. Journal of oral medicine, oral surgery, oral pathology and oral radiology, 2016. May 21, 2016 surgical closure of oroantral fistula. Recently, because of various advantages, buccal fat pad is increasingly being employed in the repair of oroantral fistula and other oral defects worldwide. Comparative study, authorahmad al nashar and hasan m. A late buccosinusal fistula in the 1516 tooth area. This retrospective single center study includes all patients with. Treatment of oroantral fistula with autologous bone graft and. Oroantral fistula oaf is an epithelialised oroantral communication oac. An oroantral fistula oaf may develop as a complication of dental extractions. Introduction oac is a complication of surgery which result in a connection between oral cavity and maxillary sinus. Pictures and surgical repair of oroantral fistula, following upper molar extraction. Conflict of interest the authors declare that have no conflict of interest.
Surgery for an oroantral fistula patient information. Scattarella a, ballini a, grassi fr, carbonara a, ciccolella f, dituri a, et al. Fistula may be closed by using alveolar, palatal or jugal mucosa flaps, after. Please refer to the sinus surgery handouts for additional information regarding the risks of sinus surgery. To show a case report of oroantral fistula and its closure. We harvested a sliding palatine flap at partial thickness. Watertight closure after removal of maxillary third molar root piece.
Ubc medicine neurology clinical skills motor, sensory, and reflex examination duration. Case of oroantral communication closure using a pedicled buccal fat pad graft. Primary closure of a sinus perforation primary closure of a sinus perforation is indicated for large. Oroantral communication closure using a pedicled buccal fat. The adipose tissue of the cheek was used by abuabara et al. Oro antral fistula it is an abnormal epithelized communication between maxillary sinus and oral cavity through perforation in the sinus wall 3. Treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants. Closure of oroantral fistula using titanium plate with. Treatment modalities for oroantral fistula oaf closure. Pdf surgical options in oroantral fistula treatment. Oroantral fistula oaf is a relatively uncommon complication of maxillary molar extraction. An oroantral fistula oaf may develop as a complication of dental extractions, as a result of infection, or as sequelae of radiation therapy, trauma, and removal of maxillary cysts or tumors. Fourteen patients with oroantral communications, ranging from 8 to 20 mm in diameter, were treated by the use of a pedicled buccal fat pad graft.
These oral contaminants may infect the sinus or induce inflammation, which may cause impaired ciliary function, problems of sinus areolation, congestion. However, these materials are not widely accepted in routine surgical closure of oaf due to cost, difficult handling, increased rate of infection, and exfoliation. The technique was considered successful when a complete closure of the oaf has occurred after three months. In patients with a concurrent sinus infection, sinus surgery is often necessary to evacuate the infection and to provide an alternative route for the sinus to drain while the fistula is healing. Doublelayered closure of oroantral fistula using buccal fat. Closure of oroantral fistula with the septal cartilage graft. Oac refers to an abnormal connection between the oral cavity and antrum or maxillary sinus.
There are advantages and disadvantages of all these techniques. Furthermore, improper treatment of oac can produce maxillary. Oroantral fistula article about oroantral fistula by the. Closure of oroantral fistula using auricular cartilage. Anteriorly based palatal flap for closure of large oroantral fistula oral surg oral med oral pathol oral radiol endod 1996. Combined bony closure of oroantral fistula and sinus lift. Closure of oroantral fistula by using buccal fat pad or. An oroantral fistula will not heal spontaneously and must be surgically repaired. Closure of oroantral fistula with buccal fat pad flap and en.
Sep 26, 20 alloplastic materials such as tantalum, gold plates and foils, hydroxyapatite blocks have been used for closure of oroantral fistula oaf. The objective of this paper is to report two clinical cases of oroantral fistula closure through bichat fat pad as well as to describe about it surgical technique, characteristics, indication and peculiarities. Oroantral fistula definition of oroantral fistula by. Jul 20, 2010 for the closure of oroantral fistula, many techniques have been described.
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