Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up.

D Penarrocha-Oltra,A Aloy-Prosper,H Pellicer-Chover,R Alonso-Gonzalez,Ma Penarrocha-Diago

doi:10.4317/jced.51741

D Penarrocha-Oltra, A Aloy-Prosper + Show 3 more

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https://doi.org/10.4317/jced.51741

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Abstract

The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction. A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient. Key words:Bichat fat pad, buccal fat pad, zygomatic implants, oroantral communication.

Highlights

Several techniques have been described to treat the atrophic maxilla (Cawood and Howell classes IV or V) [1], including zygomatic implants (ZIs) [2]
Some authors have reported ZIs removals because of recurrent sinusitis which were not resolved with antibiotics and sinus rinses [3]
This sinus infection is secondary to oroantral fistulae formation, which is speculated to appear due to deficient osseointegration of the coronal part of the ZI, thereby creating the communication between the oral and sinus cavities [3,14]

Summary

Introduction

Several techniques have been described to treat the atrophic maxilla (Cawood and Howell classes IV or V) [1], including zygomatic implants (ZIs) [2]. ZIs seemed to have high survival rates, complications are common [2], as permanent oroantral fistula formation [3] that may be responsible for recurrent sinusitis and indication for ZI removal [3]. Numerous techniques for oroantral communication (OAC) closure, including grafts and flaps of proximity or distance, such as pedicled Bichats ball (BFP) have been described [4]. Since in 1977 Egyedi [5] described the technique of closure oroantral fistula by using pedicled Bichats ball, it has become a procedure widely used in regenerative oral surgery. In the past four decades, several authors have resorted to using the Bichats ball to close oroantral communications of diverse etiology [5,6,7,8,9] either acute, chronic or recurring character [9].

Objectives

Conclusion