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 This oroantral fistula was caused by extraction of the left upper first molar. The fistulous tract is curetted and cleaned. A buccal mucosa flap is elevated. The buccal mucosa flap is advanced to cover the defect A new Modified Inverted Periosteal Flap technique for oroantral fistula repair will eliminate all the potential complications and adverse effects of both the conventional buccal advancement flap and inverted periosteal flap procedures providing a true ideal closure. This is a preview of subscription content, access via your institution
The buccal fat pad is one of many ways to close an intraoral opening into the maxillary sinus. Here is a quick video showing my technique Buccal advancement flap The buccal advancement flap is the most commonly used due to its simplicity, reliability and versatility. It involves cutting a broad based trapezoid shaped mucoperiosteal flap with two vertical incisions. The flap is cut buccally, is three sided and extends to the full depth of the sulcus In treating oroantral fistulas with buccal flaps, operator should excise an oroantral fistula surgically and must remove total epithelialized margins. Two vertical releasing incisions are made extending towards mucobuccal folds and trapezoidal flap is elevated. The flap is then advanced towards the defect and water-tight closure is done [1,2,4] A key to closing the oroantral opening is the dissection of the buccal flap lateral to the fistula. An incision that extends 15 mm anterior and posterior to the fistula is of benefit. The fistula then has an elliptical incision on each side of the opening. The core of tissue and the fistulous tract are excised . Horizontal releasing incisions are made at the most apical part of the flap, which helps to move and extend the flap to the defect without tension
BUCCAL FAT PAD FLAP IN MANAGEMENT OF OROANTRAL FISTULA. Many options are exercised to affect surgical management of oroantral fistulae. Postoperative wound dehiscence is not uncommon, and the surgical management of such fistulae often becomes increasingly difficult because of a lingering maxillary sinus infection The various techniques used to close oroantral fistula include the buccal advancement flap, palatal rotation flap, combination flaps, bone grafts, and buccal fat pad. 2 Occasionally, even a nonsurgical treatment modality like palatal splint is used. 3 These techniques can be used alone or in combination, a two-layered, or even a three-layered. Closure of Oroantral Fistula With Buccal Fat Pad Flap and Endoscopic Drainage of the Maxillary Sinus. J Craniofac Surg, 29 (8), 2153-2155. Al-Juboori, M. J., Al-Attas, M. A., Magno Filho, & L. C. (2018). Treatment of chronic oroantral fistula with platelet-rich fibrin clot and collagen membrane: a case report Keywords: Buccal flap, buccal pad of fat, oroantral fistula, palatal flap. INTRODUCTION The oroantral fistula (OAF) is a pathological communica-tion between the oral cavity and the maxillary sinus; depend-ing on the location it can be classified as alveolo-sinusal, palatal-sinusal and vestibulo-sinusal. These kinds of com
Buccal sliding flap. This trapezoidal sliding buccal flap to close Oroantral fistula was described by Moczair in 1930. This produces minimal change in the depth of the buccal vestibule. The distal shift if the flap is fabricated by incising the periosteum at the base of the flap. This flap is suitable in edentulous condition Buccal fat pad flap in management of oroantral fistula of oroantral communications with BFP only, with a reported rapid mucosalization of the exposed fat in the oral cavity.19 In our opinion in conditions where the BFP has to advance to a larger distance, it is not possible to advance a buccal mucosal flap to function as a REHRMANN ADVANCEMENT BUCCAL FLAP Procedures: • Two divergent incisions are made from each side of the fistula and a buccal mucoperiosteal flap is raised Case details: We have found the technique of two layer closure with buccal fat pad (BFP) and buccal mucoperiosteum quite useful for closure of chronic Oroantral fistula (OAF) and this article reports a case of OAF in the left first molar region of a 50 year old male, which has been closed successfully with this technique
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. 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. buccal advancement flap for the treatment of oroantral fistula. Ann Pak Inst Med Sci. 2020; 16(2): 73-77. Introduction The traditional methods employed in the repair of oroantral communication can be broadly divided into local and distant flaps. Buccal advancement and palatal rotational flaps are increasingly being employed in the repair of. . We present the case of oroantral fistula with maxillary sinusitis complicated by systemic comorbidities of advanced pulmonary disease, diabetes, and hypertension and its successful closure using a combination flap of buccal fat pad and buccal advancement flap
AA INTRODUCTION aaaasasa sss Oroantral communications (OAC) represent one of the The buccal fat pad structure can be used in order to most common surgical complications of dental correct several oral defects, such as fistulas and oroantral procedures.1,2 An oroantral fistula is a pathological communications5,7; in reconstruction after tumor. the oroantral fistula was in the left molar region and the lining of the oroantral fistual was debrided, and there was some dead bone in this area which was also debrided then closed. Doctors calls procedure coring/and closure of left oroantral fistula???? Any help on CPT would be great! THANKS . R. RNCPC0709 Networker CT: Computed tomography, OAC: Oroantral communication, OAF: Oroantral fistula Table 4: Surgical methods for treating OAC/OAF  Year Described by Method 1936 Rehrmann Buccal flap 1939 Ashley Palatal flap 1961 Goldman et al. Gold foil in flap 1974 Takahashi and Henderson Modified the palatal flap by the application of a mucosal palatal island flap An oroantral communication (OAC) is a pathologic opening between the oral cavity and the maxillary sinus. OACs occur most often as a result of surgical manipulation during dental extraction of posterior teeth but can also occur as a result of other maxillofacial surgical procedures, facial trauma or pathologic processes of the maxilla late treatment • chronic oroantral fistula:(small opening less than 5 mm) management of chronic sinusitis: • antral irrigation and fistula epithelium excision/el evation from bony wall • nasal decongestants • antibiotics • closure of small fistula with buccal/palatal flap
An oroantral fistula (OAF) can be defined as an epithelialized pathological unnatural communication between the oral cavity and the maxillary sinus .The term oroantral fistula is used to indicate a canal lined by epithelium that may be filled with granulation tissue or polyposis of the sinus membrane .They can arise as late sequelae from perforation and last at least 48-72 h Abstract. AbstractObjectiveTo review our 7-year clinical experience with the combined palatal-buccal flaps for delayed repair of oroantral fistula (OAF) and to highlight its advantages, disadvantages, and complications.Study designThe records of 18 patients with late OAF treated by combined palatal-buccal flaps from 2004 to 2010 were reviewed The buccal fat pad flap can be an effective method for closure of small- to medium-sized oroantral communicating defects. This report represents a case series of three patients with large oroantral communicating defects that were successfully treated with pedicled buccal fat pads . Methodology: This Randomized controlled clinical trial was performed in outpatient Department of Oral and Maxillofacial Surgery Unit, Punjab dental hospital, Lahore from June 2013 to December 2013. One hundred and twenty patients were included which were divided into. Key Words: Oroantral fistula, buccal advancement flap, chronic sinusitis. INTRODUCTION Oroantral communication followed by oroantral fistula (OAF) is a rare surgical complication in oral and maxillofacial surgery.1 The maxillary sinus occupies an important place in oral and maxillofacial surgery ow-ing to its close anatomic relationship to the.
buccal fat pad has been increasingly employed because it is a fast surgical procedure, is relatively easy to perform, has a high success rate (11), and is able to cover defects of up to 60×50 mm (12,13). The aim of this paper was to report a clinical case of late closure of an oroantral fistula using a rotating pedicled buccal fat pad flap The pedi- atal flaps to close OAFs, and Herbert59 suggested the cled buccal fat pad, introduced in 1977 by Egyedi19 for palatal mucoperiosteum as the tissue of choice for large closure of oroantral and oronasal communications, has fistulas. lately gained popularity because of its rich blood supply When the fistula appears buccally in the depth.
Signs and symptoms. History of recent surgery in the vicinity of maxillary sinus associated with excruciating pain in and around the region of affected sinus,along with escape of air and fluids from the nose through the mouth is an indication of oroantral fistula.The pain becomes negligible when the fistula is fully formed.The enhanced column of air, causes a change in the voice.It may also be. Hanazawa modification 1995 • Buccal flap technique that involces its use to allow creation of a buccal fat pad advancement flap to close the oroantral fistula followed by replacement of the buccal flap in its original position Palatal flaps *Insured vascularity - greater palatine artery *Thickness of the tissue closely resembles attached.
Pedicled buccal fat pad graft (PBFP) is one of the procedures used for the reconstruction of maxillary defects such as oroantral fistula, cleft palate, medication-related jaw bone necrosis, and defects formed after cysts or tumors removal .It is widely used because it has advantages such as rich vascularity, proximity to the recipient site, technical simplicity, and high success rate [1, 2] close or the use of a sliding mucosal flap, all techniques own an equal and high degree of failure. Objective: To show a case report of oroantral fistula and its closure. Case Report: A 6-month-Surgical treatment of oroantral fistula, after a tooth removal, using the buccal fat pad method as a pedicled graft associated with a sliding mucosal flap Closure of oroantral fistula with pedicled buccal fat pad and buccal advancement flap When properly dissected and mobilized, the buccal fat pad can provide 7x4x3 cm graft.10 In this case series, buccal fat pad was used to reconstruct partial maxillectomy defects, oroantral fistula , defects of cheek mucosa, maxillary tuberosity and retromolar area
was realized by a Rehrmann buccal flap. No reopening of the sinus was observed. Chin bone for oroantral fistula closure was studied in 5 patients by Haas et al. . In 3 patients a stable press-fit of the bone graft in the OAC was accomplished. In 2 patients additional plates and screws were used to obtain a rigid fixation of the graft Buccal flap; Buccal pad of fat; Oroantral fistula; Palatal flap; ASJC Scopus subject areas. Dentistry(all) Access to Document. 10.2174/1874210601206010094. Other files and links. Link to publication in Scopus. Link to citation list in Scopus. Fingerprint Dive into the research topics of 'Surgical options in oroantral fistula treatment. Closure of Oroantral Communication Using Buccal Advancement Flap: A Case Report S Sharma1, D Vandana2 1Consultant, Department of Oral and Maxillofacial Surgery, Superspeciality Dental and Maxillofacial Centre, Jammu and Kashmir, India, 2Incharge, Department of Periodontics, Superspeciality Dental and Maxillofacial Centre, Jammu and Kashmir, Indi An outpatient surgical procedure was performed with the use of local anesthetics to close the oroantral fistula with a rotating pedicled buccal fat pad flap. The healing of the wound and closure of the defect could be seen after a 30-day postoperative period, with complete epithelialization
hours. After some days, the fistula is organized more and more, preventing therefore the spontaneous closing of the perforation3. Many techniques have been described in order to prevent the consequences of a chronical presence of OAC, such as buccal flap, palatal rota-tion-advancement flap and buccal fat pad1,3-7 Buccal fat pad flap (BFP) has been used for the reconstruction of maxillary defects induced by tumor since it was first reported in 1977 . From then, many clinical applications of BFP have been introduced. The buccal fat pad appears 3 months in utero and continuously grows until birth
The buccal fat pad can be used for closure of oroantral and oronasal defects in an area between the second premolar anteriorly and a point approximately 1 cm dorsal to the pterygoid process in the soft palate ().The medial limit is about 0.5 cm from the midline, although the flap also has been used in defects just crossing the midline of the palate (Fig. 184.1A) George E. Triple-Layered Closure of an Oroantral Fistula: A Case Report. Int J Oral Maxillofac Implants. 2018;33(2):e33-e36. 27. von Wowern N. Closure of oroantral fistula with buccal flap: Rehrmann versus Môczár. Int J Oral Surg. 1982;11(3):156-165. 28. Sayed AA, Khalifa GA, Hassan SA, Mohamed FI
N2 - In view of the chronic nature of the oroantral fistula, the Caldwell Luc procedure with the nasal antrostomy was performed routinely to ensure a healthy maxillary antrum. An added advantage of the gold foil technique was that there was no loss of vestibule depth as there is with the buccal flap procedure Daif ET. Long-Term Effectiveness of the Pedicled Buccal Fat Pad in the Closure of a Large Oroantral Fistula. J Oral Maxillofac Surg 2016;74:1718-22. Yang S, Jee YJ, Ryu DM. Reconstruction of large oroantral defects using a pedicled buccal fat pad. Maxillofac Plast Reconstr Surg 2018;40:7 check for oroantral fistula smooth vs sharp edges reap proximate soft tissue. if the max tuberosity is mobile and can't be dissected from the tooth, what are your options? flap closure - usually buccal flap or palatal pedical flap sinus precautions antibiotics and decongestants
The use of the pedicled buccal fat pad (BFP) and palatal rotating flaps in closure of oroantral communication and palatal defects - Volume 113 Issue Oroantral communication (OAC) rarely occurs long after implant placement. The present report describes the rare etiology and the difficulty of the diagnosis of an uncommon OAC occurring 10 years after the implant placement in the posterior maxilla. The difficulty of the diagnosis lies in the absence of clinical symptoms of sinusitis and presence of multiunit prosthesis hiding implant failure
track and closure of defect by breasting flap that is inside layer of buccal flap and outer layer palatal flap to repair oro antral fistula with maxillary sinusitis with osteomeatal complex defect. The other case was a 55 years old female patient with left sided facial pain since 2year and left sided oral discharg Oroantral fistula less than 2mm diameter has the possibility .There is less possibility of spontaneous healing when the fistula is greater than 5mm in diameter and has been present for more than 4 weeks (4) 3.Surgical Management Of Oroantral Fistula Buccal Flap . An oroantral defect is closed using a buccal flap with a thi The buccal and the palatal flap operations for closure of oro-antral fistulae without maxillary sinusitis have the same number of failures. In conjunction with a Caldwell-Luc operation, the palatal flap is a significantly better method than the buccal flap Oroantral fistula: When oroantral communication is left open epithelial tissue may develop in its tract ----- oroantral fistula. Types •Alveolar •Palatal -Buccal flap. -Palatel flap. -Buccal pad fat flap. 3- Graft. •A flap is a unit of tissue that is transferre
Oro-antral fistulae and fractured tuberosities G. Bell1 oroantral fistula will close spontaneously. • Displaced roots should be removed from the maxillary sinus as soon as possible. is helpful to raise a two sided buccal flap, followed by removal of buccal bone, wit ORIGINAL ARTICLE Combined palatal and buccal ﬂaps in oroantral ﬁstula repair Ossama Hassan a,*, Tamer Shoukry a, Alaa Abdel Raouf b, Hassan Wahba a a Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Egypt b Department of Dentistry, Ain Shams University Specialized Hospital, Egypt Received 23 April 2012; accepted 18 June 2012. Intl J Adv Res 2016. Double layered flap for closure of recurrent oroantral fistula using buccal fat pad & palatal pedicled flap - a case report Int J Sci Study 2017. Closure of Oroantral Communication Using Buccal Advancement Flap - A Case Report World J Plast Surg 2017. Management of Oro-antral Communication & Fistula - Various Surgical Option
The autogenous flaps are buccal fat pad, buccal flap and palatal flap. Autogenous:-The buccal advancement flap was first described by Rehrmann in the year 1936. Rotation of gingivovestibular flap for closure of oroantral fistula by Krompotie and Bagatin, which is a modification of vestibular flap Here we illustrate the most common flaps used for closure of oroantral communication/fistula: the buccal flap and the palatal pedicle flap techniques. 8.2 Buccal advancement flap It has been described [ 14 , 29 ] the use of a buccal flap with a thin layer of buccinator muscle to close an oroantral defect -Buccal nerve •Injury due to flap elevation -Nasopalatine & Buccal - re-innervate and chronic oroantral fistula . Injuries to Adjacent Structures •Oroantral Communication •Oroantral Communication -Treatment - depends on size •2mm or less - no surgical intervention, sinus precautions (no. communication/ Oroantral fistula by using Buccal advancement flap & Buccal fat pad and to assess criteria for success or failure of the two surgical technique on following parameters: presence of Pain & Swelling, Infection status, Sinusitis, Fistula formation, Loss of sulcus depth. Material and method-
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. Various techniques have been examined for the closure of oroantral communications. However, the most common question is how t There was no significant difference noted with regards to the results of surgical repair of oroantral fistula, using either the buccal flap or palatal flap (Table IV). Local and general anaesthetic were em onlytwopercentwhere infection was controlled preoperatively. TableIV ResultsofSurgical RepairofOro-antralfistulae MethodsofRepai methods that are being employed in the repair of oro-antral communications include buccal advancement flaps,palatal rotation and palatal transposition flaps, tongue flaps, and naso-labial flaps.2 Mostly the buccal advancement flap and palatalrotation flap techniques are used for the repair oroantral fistula. The success of an
for treatment of oroantral fistulas, although only a few have been accepted in daily practice (16). In 1936 Rehrmannfirst published a method for closing an oroantral fistula by a simple and effi-cient method, the method of a buccal flap (17). The method of a buccal flap starts with an incision around the opening of the communication, at a dis A combination of buccal fat pad and buccal advancement flap is probably the most effective way to close an oroantral fistula. The advantage of the technique is that the vascularised buccal fat pad fills the defect below the buccal advancement flap Use of the buccal fat pad is a safe and easy method to be used in oroantral communications closure and the procedure has wide applications and a high degree of success. Good vascularization, ease of access, and minimal donor site morbidity make it a reliable soft tissue graft. Key words: Buccal fat pad, Fistula, Oroantral. JRMS June 2011; 18(2. found. Some of the patients had palatal or buccal mu-cosal injuries related to traumatic tootb extractions. Tbe remaining 23 patients bad chronic oroantral openings that occurred after dental extractions. Six of these patients had a history of previous unsuccessful attempts of fistula closure in different clinics where other methods were employed Closure of Oroantral Communication with Buccal Fat Pad Flap in Zygomatic Implant Surgery: A Case Report Eduardo Jose de Moraes, DDS, MS1 The scientific literature has demonstrated the use of the buccal fat pad (BFP) flap to cover bone grafts in the correction of maxillary osseous defects and in the closure of oroantral communications. The us
Closure of oroantral fistula with buccal flap: Rehrmann versus Moczar. TREATMENT OF OROANTRAL FISTULA - A STUDY. Combined palatal and buccal flaps in oroantral fistula repair. FREQUENCY AND FACTORS RESPONSIBLE FOR THE FORMATION OF OROANTRAL COMMUNICATION DURING EXTRACTION OF THE MAXILLARY POSTERIOR TEETH Oro-Antral Communications - A Review 1. Introduction Oro-antral communication(OAC) is an abnormal communication between the maxillary sinus and the oral cavity. If the oroantral communication is not treated, the epithelial tissues may grow in it leading to formation of oroantral fistula(OAF) Three-Layered Closure of Persistent Oroantral Fistula Using Chin Graft, Buccal Fat Pad, and Buccal Advancement Flap: A Case Report with Review of Literature Shiv Prasad Sharma Specialist Oral and Maxillofacial Surgeon, Zulﬁ General Hospital, Ministry of Health, King Abdulla Street, 11932, Saudi Arabi
When chronic oroantral fistula defects are wider than 5mm and persist for more than 3 weeks, a secondary surgical intervention is required 13. REVIEW OF THREE OPERATIVE TECHNIQUES: BUCCAL FLAP, PALATAL FLAP AND BUCCAL PAD FAT FLAP Buccal Flap Patient N. 1 was submitted to buccal flap surgery due to a traumatic upper second premolar extraction After some days, the fistula is organized more and more, preventing therefore the spontaneous closing of the perforation 3. Many techniques have been described in order to prevent the consequences of a chronical presence of OAC, such as buccal flap, palatal rotation-advancement flap and buccal fat pad 1,3-7