Abstract
PurposeMaxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure.Materials and methodsWe retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated.ResultsA total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19:6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up.ConclusionsThe incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.
Highlights
In the other two patients that both smoked, a small fistula was observed during follow-up
No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up
Oroantral fistula (OAF) is mainly caused by extraction or illness, and the treatments used to address it depend on fistula size [1, 2]
Summary
Small OAFs (< 3 mm) heal naturally over 1–2 weeks, but surgical intervention is needed for OAFs larger than 3 mm. Surgical intervention may include an advanced buccal flap and a rotational palatal flap, but a pedicled buccal fat pad (BFP) graft or skin grafts may be required for OAFs larger than 5 mm, which are often associated with an inflammatory condition [3]. Numbers of OAF patients are increasing in-line with increases in maxillary bone graft and implant placement procedures [4]. OAF closure is often attempted in BFP graft is an established method that has been widely used since 1976 when it was first described by Egyedi [6]. BFP grafts fully epithelialize 6 weeks after placement, and the procedure used is straightforward and has a high success rate [9]
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