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Large oroantral fistula repair using combined buccal and palatal flaps: a case series

Abstract

Aim

The aim was to detect the efficacy of combined buccal advancement and palatal rotational flaps in closure of large oroantral fistulas (OAFs) after dental extraction.

Materials and methods

A 3-year prospective study was conducted between February 2014 and May 2017. A total of 11 patients with large OAF after dental extraction were included in the study. Seven patients developed OAF after dental extraction of the maxillary first molar teeth, whereas two patients developed an OAF after dental extraction of the second maxillary premolars. The last two patients developed an OAF after dental extraction of the second maxillary molars.

Results

Closure of the defect was achieved in 10 cases, whereas only one case had failure. In addition to postoperative pain, swelling, and reduction of the vestibular sulcus, one patient experienced postoperative nasal adhesions between the nasal septum and inferior turbinate.

Conclusion

A combined buccal and palatal flap is efficient in closure of large delayed OAF secondary to dental extraction. Further study is required to assess new bone formation after repair of large OAF using this technique.

References

  1. Borgonovo AE, Berardinelli FV, Favale M, Maiorana C. Surgical options in oroantral fistula treatment. Open Dent J 2012; 6:94–98.

    Article  Google Scholar 

  2. Solker K, Vuksan V, Lauc T. Treatment of oroantral fistula. Acta Stomatol Croat 2002; 36:135–140.

    Google Scholar 

  3. Guven O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg 1998; 26:267–271.

    Article  CAS  Google Scholar 

  4. De Biasi M, Maglione M, Angerame D. The effectiveness of surgical management of oroantral communications: a systematic review of the literature. Eur J Oral Implantol 2014; 7:347–357.

    PubMed  Google Scholar 

  5. Yalcin S, Oncü B, Emes Y, Atalay B, Aktaş I. Surgical treatment of oroantral fistulas: a clinical study of 23 cases. J Oral Maxillofac Surg 2011; 69: 333–339.

    Article  Google Scholar 

  6. Punwutukorn C, Waikakul A, Pairuchvej V. Clinically significant oroantral communications – a study of incidence and site. Int J Oral Maxillofac Surg 1994; 23:19–21.

    Article  Google Scholar 

  7. Del Rey-Santamaría M, Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C. Incidence of oral sinus communications in 389 upper thirmolar extraction. Med Oral Patol Oral Cir Bucal 2006; 11:E334–E338.

    PubMed  Google Scholar 

  8. Awang MN. Closure of oroantral fistula. Int J Oral Maxillofac Surg 1988; 17:110–115.

    Article  CAS  Google Scholar 

  9. Hanazawa Y, Itoh K, Mabashi T, Sato K. Closure of oroantral communications using a pedicled buccal fat pad graft. J Oral Maxillofac Surg 1995; 53:771–776.

    Article  CAS  Google Scholar 

  10. Liversedge RL, Wong K. Use of the buccal fat pad in maxillary and sinus grafting of the severely atrophic maxilla preparatory to implant reconstruction of the partially or completely edentulous patient: technical note. Int J Oral Maxillofac Implants 2002; 17:424–428.

    PubMed  Google Scholar 

  11. Scattarella A, Ballini A, Grassi FR, Carbonara A, Ciccolella F, Dituri A, et al. Treatment of oroantral fistula with autologous bone graft and application of a non-reabsorbable membrane. Int J Med Sci 2010; 7:267–271.

    Article  CAS  Google Scholar 

  12. Anavi Y, Gal G, Silfen R, Calderon S. Palatal rotation-advancement flap for delayed repair of oroantral fistula: a retrospective evaluation of 63 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 96:527–534.

    Article  Google Scholar 

  13. Yilmaz T, Suslu AE, Gursel B. Treatment of oroantral fistula:experience with 27 cases. Am J Otolaryngol 2003; 24:221–223.

    Article  Google Scholar 

  14. Hernando J, Gallego L, Junguera L, Villarreal P. Oroantral communications. A retrospective analysis. Med Oral Patol Oral Cir Bucal 2010; 15:e499–e503.

    Article  Google Scholar 

  15. Haanaes HR, Pederson KN. Treatment of oroantral communication. Int J Oral Surg 1974; 3:124–132.

    Article  CAS  Google Scholar 

  16. Hajiioannou J, Koudounarakis E, Alexopoulos K, Kotsani A, Kyrmizakis DE. Maxillary sinusitis of dental origin due to oroantral fistula, treated by endoscopic sinus surgery and primary fistula closure. J Laryngol Otol 2010; 124:986–989.

    Article  CAS  Google Scholar 

  17. Proctor B. Bone graft closure of large or persistent oromaxillary fistula. Laryngoscope 1969; 79:822–826.

    Article  CAS  Google Scholar 

  18. Ahmed WM. Closure of oroantral fistula using titanium plate with transalveolar wiring. J Maxillofac Oral Surg 2015; 14:121–125.

    Article  Google Scholar 

  19. Goldman EH, Stratigos GT, Arthur AL. Treatment of oroantral fistula by gold foil closure: report of case. J Oral Surg 1969; 27:875–877.

    CAS  PubMed  Google Scholar 

  20. Zide MF, Karas ND. Hydroxylapatite block closure of oroantral fistulas: report of cases. J Oral Maxillofac Surg 1992; 50:71–75.

    Article  CAS  Google Scholar 

  21. Isler SC, Demircan S, Cansiz E. Closure of oroantral fistula using auricular cartilage: a new method to repair an oroantral fistula. Br J Oral Maxillofac Surg 2011; 49:e86–e87.

    Article  Google Scholar 

  22. Ogunsalu C. A new surgical management for oro-antral communication: the resorbable guided tissue regeneration membrane-bone substitute sandwich technique. West Indian Med J 2005; 54:261–263.

    CAS  PubMed  Google Scholar 

  23. Skoglund LA, Pedersen SS, Holst E. Surgical management of 85 perforations to the maxillary sinus. Int J Oral Surg 1983; 12:1–5.

    Article  CAS  Google Scholar 

  24. Lin PT, Bukachevsky R, Blake M. Management of odontogenic sinusitis with persistent oro-antral fistula. Ear Nose Throat J 1991; 70:488–490.

    CAS  PubMed  Google Scholar 

  25. Hassan O, Shoukry T, Raouf AA, Wahba H. Combined palatal and buccal flaps in oroantral fistula repair. Egypt J Ear Nose Throat Allied Sci 2012; 13:77–81.

    Article  Google Scholar 

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Correspondence to Ahmed N. Abdelhamid MD.

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Abdelhamid, A.N., Youssef, T. Large oroantral fistula repair using combined buccal and palatal flaps: a case series. Egypt J Otolaryngol 34, 48–54 (2018). https://doi.org/10.4103/ejo.ejo_59_17

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