Closure of oroantral communication with buccal fat pad flap


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Slide 1 : Closure of Oroantral Communication With Buccal Fat Pad Flap in Zygomatic Implant Surgery: A Case Report 1Associate Professor, Postgraduate Program, Oral Implantology Course of UNIFESO - Centro Universitário Serra dos Órgãos,Teresópolis, Rio de Janeiro, Brazil. Eduardo José de Moraes, DDS, MS1 Int J.Oral Maxillofac Implants 2008, 23 : 143-146 Site: www.coimplante.odo.br E-mail:edujm@uol.com.br
Slide 2 : The scientific literature has demonstrated the use of the buccal fat pad (BFP) flap to cover bone grafts in the correction of maxillary osseous defects and in the closure of oroantral communications. The use of the pedicled BFP flap to provide an immediate blood supply to a recipient site is recommended to provide closure of oroantral communication. The author presents a case report of zygomatic implant surgery in which the BFP flap technique was used in the closure of an oroantral communication caused by maxillofacial surgery Key words: buccal fat pad, oroantral communication, zygomatic implants ABSTRACT
Slide 3 : A 44-year-old man with complete maxillary edentulism presented for treatment complaining of an oroantral fistula. The patient reported that he had under gone orthognathic surgery 2 years earlier and received an iliac crest onlay bone graft to allow for dental implant procedures. The patient requested an evaluation for the purpose of rehabilitation with an implant-supported prosthesis. During clinical examination evidence of a Le Fort I osteotomy was observed, including scar fibrosis in the maxillary gingival labial mucous region and an oroantral fistula on the right side (Fig 1a). A clinical evaluation was performed in conjunction with imaging (panoramic radiograph and computerized tomography - CT ) (Fig 1b).The treatment plan included 3-dimensional stereolithographic models generated from the CT images (Figs 1c and 1d). CASE REPORT
Slide 4 : Fig 1a – Presurgical Panoramic radiograph Fig 1b – An oroantral fistula can be Seen over a scar area on the rigth side Fig 1c –Frontal view of the stereolithographic model Fig 1d - Frontal view of the stereolitho- graphic model
Slide 5 : Fig 2a - Flap after placement of implants Fig 2b – Definitive Radiograph ( Waters Projection)
Slide 6 : Figs 3a and 3b – BFP sutured with resorbable material (Vicryl 4-0)
Slide 7 : Figs 3c – Examination after 2 weeks Figs 3c – Examination after 4 weeks

 



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