In Reply to a Letter to the Editor

Abstract

I mainly agree with the comments made in the letter to the editor 1 Ngeow W.C. The use of Bichat's buccal fat pad to close oroantral communications in irradiated maxilla. J Oral Maxillofac Surg. 2010; 68: 229 Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar in terms of using the buccal fat pad in the irradiated maxilla. Whenever radio-osteonecrosis is suspected, it would probably be better to plan for a larger surgical procedure and a different pedicled or free flap to achieve safe closure of the defect. I would recommend the use of the buccal fat pad in irradiated patients only for the closure of small oroantral communications if the presence of radio-osteonecrosis can be precluded by diagnostic methods before surgery. From my experience, I am not sure whether hyperbaric oxygenation would really help in these cases, but it surely is worth a try. The Use of Bichat's Buccal Fat Pad to Close Oroantral Communications in Irradiated MaxillaJournal of Oral and Maxillofacial SurgeryVol. 68Issue 1PreviewI write in response to the article by Poeschl et al1 on the closure of oroantral communications using Bichat's buccal fat pad flap in their series of patients. They have done a marvelous job of closing the defects, which can be difficult and large, and their results confirmed my personal experience on the viability of this flap. Like Poeschl et al, I too irrigated the maxillary sinus before closure, except that chlorhexidine was used in my cases. In addition, I prescribed antibiotics (amoxicillin and metronidazole) to be taken 5 days before surgery and continue for another week postoperatively. Full-Text PDF