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Chronic odontogenic maxillary sinusitis (COMS), a prolonged inflammation of the maxillary sinus lasting over 12 weeks, is often a result of periapical lesions, marginal periodontitis, and complications like oro-antral communication (OAC) and fistula (OAF). OAC, commonly emerging post-teeth extraction in the lateral maxilla, lacks documented treatments using advanced platelet-rich fibrin (A-PRF). This study evaluates A-PRF's efficacy in treating COMS and immediately sealing extensive OAC. A case of a 28-year-old male with COMS linked to a periapical lesion and supernumerary molars is presented. Treatment involved extracting specific teeth while preserving adjacent ones and using A-PRF for immediate OAC closure. A-PRF, enriched with growth factors, was pivotal in healing, showcasing enhanced tissue regeneration, pain reduction, and faster recovery. The findings suggest A-PRF as an effective adjunct in treating extensive OAC and COMS, proposing its inclusion in standard treatment protocols. This study underscores A-PRF's potential in improving outcomes for patients with COMS and related complications. [ABSTRACT FROM AUTHOR]

Introduction: Oro‐control communication is one of the complications associated with dental extraction and oral surgeries. This case report presents a minimally invasive surgical approach for bone regeneration at the site of oro‐antral communication utilizing a prefabricated computer‐aided design and computer‐aided manufacturing (CAD‐CAM) allogenic bone block. Methods: A 20‐year‐old healthy female, nonsmoker, with a badly destructed upper right first molar was referred for dental implant placement after extraction. Cone beam computerized tomography images revealed the presence of a large bone defect associated with oro‐antral communication with the maxillary sinus and insufficient bone for dental implant placement. A prefabricated CAD‐CAM allogenic bone scaffold was fabricated. After surgical exposure, the scaffold was secured in place and covered with a non‐resorbable membrane. A dental implant was placed after 5 months, and a trephining biopsy was processed for histological evaluation. Results: Closure of the oro‐antral communication was clinically observed. The average width of the alveolar bone was 12 mm, and the average height was 11 mm. Histological analysis at 5‐month intervals showed thin newly formed bone trabeculae encircling remnants of graft material surrounded by osteoid tissue. The newly formed bone percentages were 32 ± 18% and 28 ± 17% volume remained after the biodegradation of the scaffold. Specific immune‐histochemical staining by anti‐vascular epithelial growth factor expression index value was 32.06%. Conclusions: A prefabricated CAD‐CAM scaffold was successfully used to seal a large oro‐antral communication and regenerate sufficient bone to place a dental implant. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to show our experience with the correct management of patients suffering from odontogenic sinusitis with oroantral communication and fistula. Methods: According to the inclusion criteria, 41 patients were enrolled in this retrospective study with a diagnosis of odontogenic sinusitis with oroantral communication and fistula; 1 patient with pre-implantological complication, 14 with implantological complications, and 26 with classical complications. Results: Two patients were treated with a fractioned combined approach, 13 patients were treated with an oral approach only, and 26 patients were treated with a combination. There was a complete resolution of the symptoms and closure of the fistula in all the patients enrolled. Conclusions: In our study, in all 41 patients, there was a surgical success. The best option is to use a multidisciplinary approach for patients suffering from odontogenic sinusitis. [ABSTRACT FROM AUTHOR]

Oro-antral fistula is one of the possible per and post operative complications encountered during avulsion of antral teeth, particularly maxillary second premolars and first molars. We report the case of a 38-year-old immunocompromised patient in whom ulcerative periodontitis caused the avulsion of several maxillary teeth with a subsequent oro-antral communication associated with a chronic maxillary sinusitis. A pedicled buccal fat pad flap was used to close this fistula. The result obtained was compared with the current data in the literature. [ABSTRACT FROM AUTHOR]

We report an interesting case of a post-traumatic actinomycotic oro-antral fistula of the left posterior maxilla, that was not salvageable via local flaps due to the size of the defect and was managed with the patient-specific titanium implant, fabricated by three-dimensional stereolithographic model planning followed by primary closure. [ABSTRACT FROM AUTHOR]

Odontogenic sinusitis (ODS) is more common than historically thought, representing 25% to 40% of all maxillary sinusitis. Due to a lack of widely accepted diagnostic criteria and a specific international diagnostic code, a true overall prevalence is unknown. ODS may be caused by either a multitude of infectious dental pathologies or complications after dental procedures. The most common dental etiologies causing ODS are apical periodontitis (endodontic) and oroantral communication or fistula after dental extraction. Less commonly, ODS can evolve after dental implant or maxillary sinus bone grafting surgeries, infection of odontogenic cysts, or advanced periodontitis., Competing Interests: Disclosure The author has received or receives honoraria for lecturing by the following companies. Straumann, Geistlich, Bego, BFS, Hess Dental, Nobel Biocare, and Quintessence., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Oro‐antral communication (OAC) is an opening between the maxillary sinus and the oral cavity, which can provide a pathway to cause an infection of the maxillary sinus. Although surgical techniques propose many advantages, several drawbacks have been reported in the previous studies. Bioactive modifiers such as platelet‐rich fibrin (PRF) are widely being used in oral surgery. Various studies have been conducted for closure of OACs using PRF. Due to the heterogeneity of the techniques found, we opted for a literature review to highlight the variety of techniques discussed in the literature. A comprehensive search of the PubMed, Google Scholar and Cochrane databases was performed for published articles between 2014 and 2021. Keywords for OAC management and repair and inclusion criteria were used to screen articles for final review. Out of 195 articles found, 12 articles were included to the study. Eight studies performed simple direct application of PRF clots, 2 studies used PRF in combination with collagen membrane and in 2 studies the treatment plan was to use buccal advancement flap reinforced by PRF. There were several variations among approaches to the closure of OAC using PRF in terms of treatment planning, pre‐ and post‐operative medication and preparation of PRF. Despite the mentioned variations, review of recent studies showed that all of the cases experienced full epithelialisation of OAC. This technique, without manipulation of any additional flaps and auto‐grafts, has several advantages. However, further research, both experimental and clinical, is necessary to unravel the success rate of using PRF in the management of OACs. [ABSTRACT FROM AUTHOR]

Background: Oro-antral communication (OAC) is a common complication following the extraction of upper molar teeth. The Archer and the Root Sinus (RS) systems can be used to classify impacted teeth in panoramic radiographs. The Archer classes B-D and the Root Sinus classes III, IV have been associated with an increased risk of OAC following tooth extraction in the upper molar region. In our previous study, we found that panoramic radiographs are not reliable for predicting OAC. This study aimed to (1) determine the feasibility of automating the classification (Archer/RS classes) of impacted teeth from panoramic radiographs, (2) determine the distribution of OAC stratified by classification system classes for the purposes of decision tree construction, and (3) determine the feasibility of automating the prediction of OAC utilizing the mentioned classification systems. Methods: We utilized multiple supervised pre-trained machine learning models (VGG16, ResNet50, Inceptionv3, EfficientNet, MobileNetV2), one custom-made convolutional neural network (CNN) model, and a Bag of Visual Words (BoVW) technique to evaluate the performance to predict the clinical classification systems RS and Archer from panoramic radiographs (Aim 1). We then used Chi-square Automatic Interaction Detectors (CHAID) to determine the distribution of OAC stratified by the Archer/RS classes to introduce a decision tree for simple use in clinics (Aim 2). Lastly, we tested the ability of a multilayer perceptron artificial neural network (MLP) and a radial basis function neural network (RBNN) to predict OAC based on the high-risk classes RS III, IV, and Archer B-D (Aim 3). Results: We achieved accuracies of up to 0.771 for EfficientNet and MobileNetV2 when examining the Archer classification. For the AUC, we obtained values of up to 0.902 for our custom-made CNN. In comparison, the detection of the RS classification achieved accuracies of up to 0.792 for the BoVW and an AUC of up to 0.716 for our custom-made CNN. Overall, the Archer classification was detected more reliably than the RS classification when considering all algorithms. CHAID predicted 77.4% correctness for the Archer classification and 81.4% for the RS classification. MLP (AUC: 0.590) and RBNN (AUC: 0.590) for the Archer classification as well as MLP 0.638) and RBNN (0.630) for the RS classification did not show sufficient predictive capability for OAC. Conclusions: The results reveal that impacted teeth can be classified using panoramic radiographs (best AUC: 0.902), and the classification systems can be stratified according to their relationship to OAC (81.4% correct for RS classification). However, the Archer and RS classes did not achieve satisfactory AUCs for predicting OAC (best AUC: 0.638). Additional research is needed to validate the results externally and to develop a reliable risk stratification tool based on the present findings. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to show our experience with the correct management of patients suffering from odontogenic sinusitis with oroantral communication and fistula. Methods: According to the inclusion criteria, 41 patients were enrolled in this retrospective study with a diagnosis of odontogenic sinusitis with oroantral communication and fistula; 1 patient with pre-implantological complication, 14 with implantological complications, and 26 with classical complications. Results: Two patients were treated with a fractioned combined approach, 13 patients were treated with an oral approach only, and 26 patients were treated with a combination. There was a complete resolution of the symptoms and closure of the fistula in all the patients enrolled. Conclusions: In our study, in all 41 patients, there was a surgical success. The best option is to use a multidisciplinary approach for patients suffering from odontogenic sinusitis.

OBJECTIVE: To compare between double layer closure and buccal advancement flap in the management of Oro-antral fistula METHODOLOGY: This Comparative cross sectional study was conducted on 30 patients with oral antral fistula in Maxillofacial Surgery Department, Liaquat University of Medical & Health sciences Hyderabad. The study was conducted from March 2013 to February 2019. Selection of patients was made on inclusion criteria of patient having OAF for more than 15 days, irrespective of location and side. Patients who developed Oro-antral fistula (OAF) because of any pathology or its treatment, and patient having bleeding tendency were excluded. Division of two groups to avoid any bias in this study was done by using random number table. Group-I was treated with buccal advancement flap while group-II with “double layer closure “with buccal fat pad” and 2nd layer with buccal advancement. The outcome was evaluated for any postoperative complications like wound dehiscence, necrosis, infection. RESULTS: Males and females were 67% and 33% respectively. The mean age was 35.03±9.56 years. Maxillary molars were the common site for OAF. Maxillary first molar followed by second molar site was ranked according to frequency of this condition. Buccal advancement procedure was used in group A and in this cluster 86.6% cases were successful. In Group B, a double layered closure procedure was used and the success rate was 93.3% which is statistically not significant. CONCLUSION: Double-layered closure using BFP with buccal advancement flap should be kept as a valuable option in mind in the management of OAF.

Background: Oro-antral communication (OAC) is a common complication following the extraction of upper molar teeth. The Archer and the Root Sinus (RS) systems can be used to classify impacted teeth in panoramic radiographs. The Archer classes B-D and the Root Sinus classes III, IV have been associated with an increased risk of OAC following tooth extraction in the upper molar region. In our previous study, we found that panoramic radiographs are not reliable for predicting OAC. This study aimed to (1) determine the feasibility of automating the classification (Archer/RS classes) of impacted teeth from panoramic radiographs, (2) determine the distribution of OAC stratified by classification system classes for the purposes of decision tree construction, and (3) determine the feasibility of automating the prediction of OAC utilizing the mentioned classification systems. Methods: We utilized multiple supervised pre-trained machine learning models (VGG16, ResNet50, Inceptionv3, EfficientNet, MobileNetV2), one custom-made convolutional neural network (CNN) model, and a Bag of Visual Words (BoVW) technique to evaluate the performance to predict the clinical classification systems RS and Archer from panoramic radiographs (Aim 1). We then used Chi-square Automatic Interaction Detectors (CHAID) to determine the distribution of OAC stratified by the Archer/RS classes to introduce a decision tree for simple use in clinics (Aim 2). Lastly, we tested the ability of a multilayer perceptron artificial neural network (MLP) and a radial basis function neural network (RBNN) to predict OAC based on the high-risk classes RS III, IV, and Archer B-D (Aim 3). Results: We achieved accuracies of up to 0.771 for EfficientNet and MobileNetV2 when examining the Archer classification. For the AUC, we obtained values of up to 0.902 for our custom-made CNN. In comparison, the detection of the RS classification achieved accuracies of up to 0.792 for the BoVW and an AUC of up to 0.716 for our custom-made CNN. Overall, the Archer classification was detected more reliably than the RS classification when considering all algorithms. CHAID predicted 77.4% correctness for the Archer classification and 81.4% for the RS classification. MLP (AUC: 0.590) and RBNN (AUC: 0.590) for the Archer classification as well as MLP 0.638) and RBNN (0.630) for the RS classification did not show sufficient predictive capability for OAC. Conclusions: The results reveal that impacted teeth can be classified using panoramic radiographs (best AUC: 0.902), and the classification systems can be stratified according to their relationship to OAC (81.4% correct for RS classification). However, the Archer and RS classes did not achieve satisfactory AUCs for predicting OAC (best AUC: 0.638). Additional research is needed to validate the results externally and to develop a reliable risk stratification tool based on the present findings.

OBJECTIVE: To compare between double layer closure and buccal advancement flap in the management of Oro-antral fistula METHODOLOGY: This Comparative cross sectional study was conducted on 30 patients with oral antral fistula in Maxillofacial Surgery Department, Liaquat University of Medical & Health sciences Hyderabad. The study was conducted from March 2013 to February 2019. Selection of patients was made on inclusion criteria of patient having OAF for more than 15 days, irrespective of location and side. Patients who developed Oro-antral fistula (OAF) because of any pathology or its treatment, and patient having bleeding tendency were excluded. Division of two groups to avoid any bias in this study was done by using random number table. Group-I was treated with buccal advancement flap while group-ll with "double layer closure "with buccal fat pad" and 2nd layer with buccal advancement. The outcome was evaluated for any postoperative complications like wound dehiscence, necrosis, infection. RESULTS: Males and females were 67% and 33% respectively. The mean age was 35.03±9.56 years. Maxillary molars were the common site for OAF. Maxillary first molar followed by second molar site was ranked according to frequency of this condition. Buccal advancement procedure was used in group A and in this cluster 86.6% cases were successful. In Group B, a double layered closure procedure was used and the success rate was 93.3% which is statistically not significant. CONCLUSION: Double-layered closure using BFP with buccal advancement flap should be kept as a valuable option in mind in the management of OAF. [ABSTRACT FROM AUTHOR]

Mucormycosis is a very rare fungal infection, characterized by vascular invasion, rapid progression and high mortality. Individuals suffering from systemic diseases influencing the immune system are predisposed to this infection which is caused by saprophytic fungi belonging to the class of Mucormycetes in the order of Mucorales. In this paper, we present an unusual case of mucormycosis of the maxillary sinus in an immunocompetent patient with oro-antral fistula. The infection may occur in either a fulminant or chronic form. In the patient described, the disease was chronic and characterized by a mild course with local symptoms. In the disseminated form of mucormycosis, the mortality rate is almost 100%. A definitively higher survival rate is observed in immunocompetent patients with a localized form of the infection. Diagnosis of the disease is very difficult because of its clinical and radiological similarity to the more common fungal infection, aspergillosis. Early diagnosis plays a key role in the course of treatment and allows to reduce the scope of surgical intervention. According to most authors, first line treatment should be the liposomal form of amphotericin B. Some also advise surgical treatment involving the removal of fungal masses. In the patient described, both surgical and pharmacological treatment was conducted resulting in the complete resolution of the fungal infection after 12 months. [ABSTRACT FROM AUTHOR]

Various surgical techniques have been developed for oro-antral fistula (OAF) closure, all of which have some drawback. Twenty consecutive patients with an OAF were enrolled in this prospective study. A trapezoid full-thickness flap extending from the palatal area to the buccal gingiva was raised, including the fistula at its centre. The palatal free end aspect was split into two layers and the deep periosteal layer was folded deep to the flap over the bony defect, thereby sealing the fistula. The superficial layer was returned to its primary position and sutured. The patients were followed for 3 months. Nineteen patients showed immediate OAF closure. One patient showed a residual oro-antral communication of 0.5 mm in diameter that resolved spontaneously within 4 weeks. The pain level (on a visual analogue scale) was highest at the first follow-up week, with a mean score of 5.5, which decreased to a mean level of 2.5 in the second week and 0 in the fourth week. The mean satisfaction level was 9.85 on a scale of 0–10 (10 representing total satisfaction). The pedicled palatal periosteal flap is a simple and effective surgical technique with high predictability and patient satisfaction levels, offering one more alternative for the treatment of OAF. [ABSTRACT FROM AUTHOR]

Resumen Objetivo: Presentar cuatro situaciones clínicas de comunicaciones bucosinusales crónicas que fueron resueltas mediante tres técnicas quirúrgicas diferentes con un mismo protocolo, que consta de tres principios fundamentales. Primero, el seno maxilar se debe encontrar libre de infección, permeable y funcional. Segundo, el cierre debe realizarse en dos planos, debido a las diferentes características histológicas de las cavidades. Tercero, el colgajo de cierre debe ser bien vascularizado y estar libre de tensión. Casos clínicos: Se trataron cuatro casos de comunicaciones bucosinusales crónicas siguiendo los tres principios fundamentales, para lo cual se utilizaron tres técnicas quirúrgicas diferentes: colgajo de avance vestibular, bola adiposa de Bichat y raqueta palatina. Todos los casos evolucionaron de manera favorable y sin recurrencia. Conclusión: A pesar de que en la literatura ha sido descripta una gran cantidad de técnicas quirúrgicas para el tratamiento de las comunicaciones bucosinusales crónicas, concluimos que el éxito del cierre dependería de los principios fundamentales previamente enumerados y de la correcta selección del colgajo para cada caso clínico. Palabras clave: Cirugía bucal, fístula oroantral, seno maxilar. Abstract Aim: To analyze four clinical cases of chronical oroantral communications that were treated with three different surgical techniques, using a unique protocol following three principles: the maxillary sinus must be free of infection, permeable and functional; the closure must be double layered (due to the different histological characteristics of the cavities); the closing flap must be well vascularized and free of tension. Cases report: Four oroantral fistulas were treated following the three basic principles, three different surgical techniques were used: a buccal flap, a palatal flap and a buccal fat pad. All surgical wounds healed uneventfully and without recurrence. Conclusion: Despite the wide range of techniques proposed in the literature, we conclude that the success of the closure of the oroantral fistulas showed to depend on the principles previously stated and the correct selection of the flap for each clinical situation. Key words: Maxillary sinus, oro-antral fistula, oral surgical.

Copyright of Revista de la Asociación Odontológica Argentina is the property of Asociacion Odontologica Argentina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents etiological factors of iatrogenic character enabling maxillary sinusitis onset as well as its pathogenesis, clinical course features, and contemporary diagnosis. Surgical operative modalities were compared, and tactics of patient management in rehabilitation period was described. The necessity to work out novel methods of complex treatment and rehabilitation for patients with maxillary sinusitis was substantiated.

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Brief Background Oro antral fistula (OAF) is a common condition encountered in day to day practice. It is an unnatural pathological communication between the oral cavity and maxillary sinus. There are various aetiological factors and different treatment options available. The present case report describes closure of OAF of a 34 year old male patient by the use of buccal fat pad. [ABSTRACT FROM AUTHOR]

Brief Background Oro-antral fistula (OAF) is a pathological communication between oral cavity and maxillary sinus which usually occurs due to traumatic extraction of maxillary molars, or dentoalveolar fractures of posterior maxilla, or osteomyelitis or pathologies involving the maxillary bone. Material The most commonly employed flaps for management of oro-antral fistula are buccal advancement flap and palatal rotation flap. Since there are various advantages of buccal pad of fat, therefore it was incorporated with the buccal flap. This case report revealed a case of double layer closure of oro-antral fistula using buccal pad fat and buccal advancement flap Discussion This is easily graft harvested under local anesthesia that enhances its simplicity and versatility. The technique of harvesting the buccal fat pad consists of blunt and gentle dissection with curved artery forceps behind the maxillary tuberosity region. Since Buccal fat pad resides below the Buccinator muscle. It is always recommended that attempts should be made to maintain the capsule of the buccal fat as the blood supply resides within its capsule Summary and Conclusions We can conclude that double-layered closure using buccal fat pad with buccal advancement flap provides a better stability and it also enhances wound healing of surgically repaired Oro -Antral fistula. [ABSTRACT FROM AUTHOR]

The oro-antral communication (OAC) is a pathological opening between the maxillary sinus and the oral cavity. When it does not close spontaneously or if it is not treated, it remains permeable and epithelializes to develop into an oro-antral fistula (OAF) and can cause maxillary sinusitis. The authors present through 5 clinical cases the different steps of the surgical protocols opting for the buccal fat pad flap and the advanced buccal flap to treat OAF/OAC. Surgical closure of the OAC within 48 h is recommended to avoid complications. Several alternative techniques have been described over the years for the management of the OAC and OAF, with their advantages and limitations. The most commonly used surgical flaps are of two types: the advanced buccal flap and the buccal fat pad (BFP) flap. The adequate availability of the advanced buccal flap and the buccal fat pad (BFP) flap in the majority of patients, the easy handling, the minimal donor site morbidity as well as the excellent blood supply make them perfect flaps for the closure of OAF/OAC. However, follow-up remains a key point and very important to avoid complications. The present case series was limited by the small number of patients and the authors recommend a study with larger groups. • Surgical closure of the oro-antral communication within 48 hours is recommended to avoid complications. • Oro-antral fistula should be managed promptly by creating a barrier between oral cavity and maxillary sinus to prevent maxillary sinusitis. • Successful closure of oro-antral fistula or communication depends on compliance with the indications and surgical protocol. • Follow-up remains very important to avoid complications. [ABSTRACT FROM AUTHOR]

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Aim: The aim of this study was to assess the role of MDCT and the dedicated dental software in assessment of the periapical abscesses of the maxillary teeth and in detection of abnormal fistula as well as post intervention complications. Materials and methods: This study was conducted on 20 patients with periapical abscess of the maxillary teeth. MDCT machines were used in examination of all patients. Workstation was used for manipulation of data. Dedicated dental software was used in the evaluation of all diseased teeth. Results: Fourteen patients had their abscesses involving the maxillary molar and premolar teeth, six of them showed associated oro-antral fistula (42.8%). Four patients had their abscesses surrounding the apices of the incisors, two of them showed associated oro-nasal fistula (50%). None of the patients with periapical abscesses surrounding the roots of the canine teeth (n =2) showed abnormal fistulization. Nine cases (45%) showed missing crowns and retained roots due to previous trials of extractions. Two cases (10%) of fracture of the maxillary alveolar process complicating trials of previous extraction were also encountered. Conclusion: The MDCT with its outstanding image quality of the bony structures supported by its 3-D and VR capabilities can detect the periapical dental abscess in a 3-D fashion, accurately define its location, size and extent and is excellent in evaluation of possible fistula. As compared to panorama X-ray, MDCT was more accurate in diagnosis of abnormal fistula and associated fracture of the alveolar process of the maxillary bone. [Copyright &y& Elsevier]

The paper describes a new technique for closure of the oro-antral communication, in which both hard (bone) and soft tissue closure was achieved. The technique uses a Guided Tissue Regeeration (GTR) membrane and Freez Dried Mineralized Bone (FDMB) allograft for closure of the defect. Aim of the study was to assess the advantages of the surgical management of oro-antral communications using resorbable GTR membrane and FDMB sandwich technique. A total 10 patients were selected in whom dental extractions were complicated by formation of oro-antral communication (OAC). The resorbable guided tissue regeneration membrane (PERIOCOL-GTR) and freeze dried mineralized bone allograft material was used. Some cancellous granules of freeze dried bone allograft was sandwiched between sheaths of appropriately trimmed collagen membrane which was previously sutured together on three sides using 3/0 resorbable polyglycolic acid suture (vicryl). The fourth side was then adequately closed using the same suture after the bone graft had been inserted, thus creating a closed sandwich. The prepared sandwich was then tucked into the OAC in such a way that it formed a convexity towards the sinus and a concavity towards the alveolar bone. The rough surface of the sandwich is faced to the alveolar bone and additional bone graft is filled into this concavity. Suturing done without tension. Post-operative orthopantomogram was taken to radiologically quantify the amount of bone grafting/augmentation and closure of oro-antral fistula. There was an average of 11.84 mm bone formation after 6 months, the average width preserved and obtained was 6.9 mm. By the end of 4 months there was evidence of bone formation in 7 subjects and in three subjects bony trabeculae formed was almost similar to the adjacent bone. By the end of 6 months follow-up of 7 subjects showed trabeculae indistinguishable from the adjacent bone. The study was done in 10 patients with a follow-up period of 6 months and found to be excellent in the formation of new bone. The technique is simple and excellent for closure of the oro-antral communications especially when subsequent placement of end osseous implant is considered without the need of donor site surgery for bone grafting. [ABSTRACT FROM AUTHOR]

Although the buccal fat pad (BFP) was originally used as an alternative method for the closure of small to medium-sized oroantral and oronasal communications, its use has now been extended to use after excision of oral pre malignant lesions. This report describes experience with this technique [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to compare the clinical results of pedicled buccal fat pad flap (PBFPF) with the standard buccal flap in the closure of oro-antral fistula (OAF). Twenty-two patients aged 25–56 years with oro-antral communication were randomly divided into two groups using Rand List 1.2 software. In group 1, OAF was treated with the classic buccal sliding flap and in group 2 a pedicled buccal fat pad was used. All patients were visited 48h, 1 week and 1 month after surgery for assessment of primary (success of surgery) and secondary outcomes (pain, swelling, maximum mouth opening (MMO) reduction). Both methods were equally successful for the closure of OAF. The pain score was statistically greater in the experimental group (U =9, P =0.001). MMO was statistically less in the experimental group 2 and 7 days after surgery (P <0.001). 1 month after surgery, no statistically significant difference was found in MMO between the two groups (P =0.09). In general, the PBFPF group had more pronounced swelling than the control group. Despite the statistical evidence, none of the patients complained of pain and swelling following the PBFPF procedure. [Copyright &y& Elsevier]

Abstract: Use of a tongue flap has been advocated for the treatment of various defects in the mouth, and application for the closure of extended oro-nasal fistulae is widespread because of its rich blood supply. We report herein closure of an oro-antral fistula after partial maxillectomy using a laterally based tongue flap. A 63-year-old man was diagnosed as upper gingival carcinoma. Partial maxillectomy was performed under general anesthesia. After the operation, maxillary defect was sealed with partial denture. About 5 years postoperatively, the patient complained of an unpleasant feeling of the partial denture. Closure operation was performed under general anesthesia. A tongue flap was raised from the dorsum of the tongue including mucosa and underlying muscle, based laterally. The tongue flap was turned upward and the tip was sutured to the lateral edge of the maxillary defect, then the base was sutured to the middle of the maxillary defect. The flap was well vascularized and necrosis of the flap did not occur. Five months postoperatively, the oro-antral fistula was kept completely closed. Therefore, closure of the oro-antral fistula using a tongue flap is useful for medium-sized maxillectomy defects. [Copyright &y& Elsevier]

Purpose: To evaluate the efficacy of buccal fat for closure of oro-antral fistula with chronic maxillary sinusitis. Material and methods: We here report a patient with left chronic maxillary sinusitis secondary to the extraction of the left maxillary second molar with oro-antral communication, in whom antral lavage was carried out along with extraction of the left first and third maxillary molars. The oro-antral communication including the entire alveolar defect was closed using a buccal fat pad transfer. The buccal fat pad (BFP) was evaluated post-operatively on a weekly basis until it was fully epithelised. Result: Satisfactory healing of the recipient site was noted and the color of normal mucosa was attained at 3 months indicating uneventful healing. Conclusion: The pedicled buccal fat pad has been widely used for the repair of oral defects. Results suggest that this is a logical, convenient and reliable technique for treatment of oro-antral fistula with chronic maxillary sinusitis. [ABSTRACT FROM AUTHOR]

The Buccal Fat Pad (BFP) has been increasingly employed in the reconstruction of intra-oral defects since the procedure was first described by Egyedi. Although the use of BFP for closure of oro-antral communications has been reported in literature, it is either not a common practice or is under reported in India. This article describes predictive results with 2 cases of chronic oro-antral fistula using pedicled BFP. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the application of acellular dermal matrix and acellular bone matrix in the management of oro-antral fistula., Methods: Nine patients with oro-antral fistula (with defect greater than 5 mm×5 mm) after maxillary cyst resection or maxillary molar extraction were selected. The defects were repaired by the simultaneous implantation of acellular dermal matrix and acellular bone matrix., Results: The incisions of nine patients were all primary healing. After 6 months of follow-up, the oro-antral communication healed well, and no symptom such as nasal congestion or runny nose was observed. The clinical and CT examinations confirmed wound healing., Conclusions: The usage of acellular dermal matrix and acellular bone matrix is a reliable repairing method for ora-antral fistula.

Abstract: We describe the case of a patient with an oroantral fistula that healed successfully after conservative treatment. [Copyright &y& Elsevier]

Aim of the Study: The odontogenic sinusitis has an incidence between 38 and 40.6%. Increased risk of maxillary sinusitis has been reported with the presence of periapical abscesses, periodontal disease, dental trauma, tooth extraction and implant placement when the sinusal membrane is perforated., Materials and Methods: A patient with odontogenic maxillary sinusitis associated with oro-nasal fistula was treated., Results: The follow-up at six months showed the complete resolution of maxillary sinusitis, palatal fistula got closed and pain symptoms disappeared., Conclusion: This case report describes a rare complication of odontogenic maxillary sinusitis: the oro-nasal fistula.