THE USE OF BUCCAL ANTROSTOMY BONE AS A GRAFT FOR CLOSURE OF ORO- ANTRAL FISTULA

Document Type : Original Article

Authors

1 BDS, MS, Alexandria University, Faculty of Dentistry, Alexandria University, Egypt

2 Professor at Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt

3 Assistant Professor at Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt.

Abstract

INTRODUCTION: Oroantral fistula is an epithelialized, pathological and unnatural communication between the oral cavity and the maxillary sinus. OBJECTIVES: The aim of this study was to evaluate the use of buccal antrostomy bone as a graft for closure of oroantral fistula clinically and radiographically. MATERIALS AND METHODS: A prospective study was done on 10 patients complaining of oroantral fistulae following extraction of maxillary posterior teeth. The bony defect of the oroantral fistula was closed by anterior wall of maxillary sinus as a graft material and fixed to the surrounding bone using N-Butyl-2-Cyanoacrylate (Histoacryl®), then covered by buccal advancement flap. The patients were followed up clinically after 4, 6, 8 and 12 weeks postoperatively Radiographic evaluation was performed by cone beam computed tomography (CBCT) preoperatively and after 12 weeks postoperatively. RESULTS: Evaluation of the patients revealed that proper healing of the wound occurred in most of the patients except in 3 patients whose bone graft was exposed and removed. Radiographicaly, significant amount of bone was formed comparing the preoperative and postoperative CBCT of the patients. CONCLUSIONS: According to the results of the present study, it is concluded that the use of the buccal antrostomy wall as a bone graft fixed with N butyl cyanoacrylate proved successful results in closure of large oroantral fistula.

Keywords

Main Subjects

References

  1. Ogunsalu C. A new surgical management for oro-antral communication: the resorbable guided tissue regeneration membrane-bone substitute sandwich technique. West indian medical journal. 2005;54:261-3.
  2. Hassan O, Shoukry T, Raouf AA, Wahba H. Combined palatal and buccal flaps in oroantral fistula repair. Egyptian Journal of Ear, Nose, Throat and Allied Sciences. 2012;13:77-81.
  3. Proctor B. Bone graft closure of large or persistent oromaxillary fistula. Laryngoscope. 1969;79:822-6. Quoted from: Abdelhamid AN, Youssef T. Large oroantral fistula repair using combined buccal and palatal flaps: a case series. Egypt J Otolaryngol. 2018;34:48-54.
  4. Joshi A, Kostakis GC. An investigation of post-operative morbidity following iliac crest graft harvesting. Br Dent J. 2004;196:167-71.
  5. Nkenke E, Radespiel-Troger M, Wiltfang J, SchultzeMosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin Oral Implants Res. 2002;13:514-21.
  6. Watzak G, Tepper G, Zechner W, Monov G, Busenlechner D, Watzek G. Bony press- t closure of oroantral fistulae: a technique for pre-sinus lift repair and secondary closure. J Oral Maxillofac Surg. 2005;63:1288-94.
  7. Von Wowern N. Closure of oroantral fistula with buccal flap: Rehrmann versus Môczár. Int J Oral Surg. 1982;11:156-65. Quoted from: Bhatt R, Barodiya A, Singh S, Awasthi N. Comparison between pedicled buccal fat pad flap and buccal advancement flap for closure of oroantral communication. J Appl Dent Med Sci. 2018;4:55-62.
  8. Shermak MA, Wong L, Inoue N, Crain BJ, Im MJ, Chao EY, . Fixation of the craniofacial skeleton with butyl-2- cyanoacrylate and its effects on histotoxicity and healing. Plast Reconstr Surg. 1998;102:309-18.
  9. Foresta E, Torroni A, Gasparini G, Saponaro G, Longo G, Boniello R, et al. Use of N-butyl-2-cyanoacrylate (Glubran2®) in fractures of orbital-maxillo-zygomatic complex. J Oral Maxillofac Surg. 2015;14:761-4.
  10. El-Fattah HA, Nour YA, El-Daly A. Endoscopic radical antrectomy: a permanent replacement for the Caldwell–Luc operation. J Laryngol Otol. 2008;122:268-76.
  11. Jovanović G, Burić N, Tijanić M. Stimulation of mucoperiostal slice epithelization by small power laser after the primary plastic of oroantral communication. Medicinski pregled. 2010;63:188-93.
  12. Delgado Galindez B, Gonzalez Sanchez OJ, Villalpando Carrcon M, Albores Zuniga D. Surgical correction of oroantral fistulae with integration of mandibular bone. Rev Med Inst Mex Seguro Soc. 2005;43:167-72.
  13. Hirata Y, Kino K, Nagaoka S, Miyamoto R, Yoshi-masu H, Amagasa T. A clinical investigation of oro-maxillary sinus perforation due to tooth extraction. Kokubyo Gkkizasshi. 2001;68:249-53.
  14. Arbi E, Saleh M. management of an oroantral fistula-a clinical study of 30 cases. Pak oral dent j. 2006;26:55-8.
  15. Yabroudi F, Dannan A. A comparison between submucosal connective tissue palatal flap and conventional pedicle palatal flap for the closure of oroantral fistulae. Internet J Dent Sci. 2008;8:24-7
  16. Guven O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg. 1998;26:267-71.
  17. Hasegawa T, Tachibana A, Takeda D, Iwata E, Arimoto S, Sakakibara A, et al. Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth. Oral Maxillofac Surg. 2016;20:369-75.
  18. Hernando J, Gallego L, Junquera L, Villarreal P. Oroantral communications. A retrospective analysis. Med Oral Patol Oral Cir Bucal. 2010;15:499-503.
  19. Abuabara A, Cortez AL, Passeri LA. de Moraes M, Moreira RW. Evaluation of different treatments for oroantral/oroanasal communications: experience of 112 cases. Int J Oral Maxillofac Sur. 2006;35:155-8.
  20. Khandelwal P, Hajira N. Management of oro-antral communication and fistula: various surgical options. World journal of plastic surgery. 2017;6(1):3.
  21. Eneroth CM, Mortensson G. Closure of antro-alveolar fistulae. Acta Otolaryngol. 1996;53:447-57.
  22. Ahmad M, Jenny J, Downie M. Application of cone beam computed tomography in oral and maxillofacial surgery. Aust Dent J. 2012;57:82-94.
Alexandria Dental Journal
Volume 44, Issue 3
December 2019
Pages 15-21

Files

Share

How to cite

Statistics