Use of autogenous bone graft of the anterior wall of the maxillary sinus in the management of oroantral fistula

Abstract

Introduction: The oroantral fistula consists of a persistent communication between the maxillary sinus and the buccal cavity, being a complication resulting from traumas, pathologies or dental extractions. Objective: To present a clinical case of oroantral fistula closure using autogenous bone graft from the anterior sinus wall as a treatment option. Materials and Methods: Patient with a history of traumatic extraction of the upper left molars about 4 months ago. During the clinical examination, there was an orifice in the left maxillary alveolar crest, suggestive of oroantral fistula, responding positively to the Valsalva maneuver. Panoramic radiographic examination evidenced continuity between the oral cavity and the left maxillary sinus, which presented with opacification, suggestive of acute maxillary sinusitis on the left side. Sinusitis was treated within 15 days. After treatment, we evaluated the patient who was asymptomatic and, at that moment, the surgical procedure for the oroantral fistula closure was planned, removing a bone block from the anterior wall of the left maxillary sinus presenting the sinus membrane and grafting with fixation using System 1.5 mm with an "L" plate and four bolts. Conclusion: This surgical technique is useful for the closure of chronic oroantral fistulas in patients with oroantral fistulas.Descriptors: Oroantral Fistula; Bone Transplantation; Maxillary Sinus.ReferencesMartín-Granizo R, Naval L, Costas A, Goizueta C, Rodriguez F, Monje F, Muñoz M, Diaz F. Use of buccal fat pad to repair intraoral defects: review of 30 cases. Br J Oral Maxillofac Surg. 1997;35(2):81-4.Yilmaz T, Suslu AE, Gursel B. Treatment of oroantral fistula:experience with 27 cases. Am J Otolaryngol. 2003;24(4):221-23.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(5):527-34.Haas R, Watzak G, Baron M. A preliminary study of monocortical bone grafts for oroantral fistula closure. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(3):263-66Zide MF, Karas ND. Hydroxylapatite block closure of oroantral fistulas: report of cases. J Oral Maxillofac Surg. 1992;50(1):71-5.Poeschl PW, Baumann A, Russmueller G, Poeschl E, Klug C, Ewers R. Closure of oroantral communications with Bichat's buccal fat pad. J Oral Maxillofac Surg. 2009;67(7):1460-6.Jain MK, Ramesh C, Sankar K, Lokesh Babu KT. Pedicled buccal fat pad in the management of oroantral fistula: a clinical study of 15 cases. Int J Oral Maxillofac Surg. 2012;41(8):1025-29.Amaratunga NA. Oro-antral fistulae--a study of clinical, radiological and treatment aspects. Br J Oral Maxillofac Surg. 1986;24(6):433-37.Proctor B. Bone graft closure of large or persistent oromaxillary fistula. Laryngoscope 1969;79(5):822-26.Visscher SH, van Minnen B, Bos RR. Closure of oroantral communications: a review of the literature. J Oral Maxillofac Surg. 2010;68(6):1384-91.Visscher SH, van Roon MR, Sluiter WJ, van Minnen B, Bos RR. Retrospective study on the treatment outcome of surgical closure of oroantral communications. J Oral Maxillofac Surg. 2011;69(12):2956-61.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(7):771-75.