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Combined palatal flap and titanium mesh for oroantral fistula closure.

de Souza Lopes PH, Sampaio Dde O, de Souza Menezes BL, do Nascimento DF, Torres BC - Ann Maxillofac Surg (2015 Jan-Jun)

Bottom Line: The oroantral fistula (OAF) is an epithelialized communication between the oral cavity and the maxillary sinus.In most of the cases, this communication occurs after molars and premolars extractions, but other factors may be cause of the communication, such as trauma.This article demonstrates an alternative surgical technique illustrated with a case report in which we perform the surgical treatment of OAF with palatal flap rotation combined with the use of titanium mesh in a victim of gunshot projectile wound in oral cavity.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Hospital Regional do Agreste, Caruaru, Pernambuco, Brazil.

ABSTRACT
The oroantral fistula (OAF) is an epithelialized communication between the oral cavity and the maxillary sinus. In most of the cases, this communication occurs after molars and premolars extractions, but other factors may be cause of the communication, such as trauma. This article demonstrates an alternative surgical technique illustrated with a case report in which we perform the surgical treatment of OAF with palatal flap rotation combined with the use of titanium mesh in a victim of gunshot projectile wound in oral cavity.

No MeSH data available.


Related in: MedlinePlus

Healing status of oroantral fistula on 40th postclosure day
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Figure 6: Healing status of oroantral fistula on 40th postclosure day

Mentions: Patient under general anesthesia, was infiltrated lidocaine 2% + epinephrine 1:200,000 and conducted probing around the fistula to demarcate the bone defect. The pathological tract and polypoid antral tissue were soon removed and copious irrigation with saline was performed. An intrasulcular and paramedian subperiosteal incisions were made on palate, thus forming a full-thickness palatal flap and possible full view of the bone defect of approximately 2 cm in diameter [Figure 4]. A titanium mesh measuring 3 cm × 3 cm, 0.1 mm thick with four screws 1.5 mm × 5 mm was installed in the place [Figure 5], covered with palatine flap and sutured with 4-0 polyglactin 910. The denudated place was covered with surgical cement (PerioBond - Dentsply®- Petrópolis/RJ - Brasil) and removed after 2 weeks. Postoperatively, patient received antibiotics, anti-inflammatory, analgesic and nasal decongestant. We observed proper surgical site healing after the surgical cement was removed, without infection and/or dehiscence. The patient remained under follow-up of 06 months, when complete closure of OAF and tissue repair was noted [Figures 6 and 7].


Combined palatal flap and titanium mesh for oroantral fistula closure.

de Souza Lopes PH, Sampaio Dde O, de Souza Menezes BL, do Nascimento DF, Torres BC - Ann Maxillofac Surg (2015 Jan-Jun)

Healing status of oroantral fistula on 40th postclosure day
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555957&req=5

Figure 6: Healing status of oroantral fistula on 40th postclosure day
Mentions: Patient under general anesthesia, was infiltrated lidocaine 2% + epinephrine 1:200,000 and conducted probing around the fistula to demarcate the bone defect. The pathological tract and polypoid antral tissue were soon removed and copious irrigation with saline was performed. An intrasulcular and paramedian subperiosteal incisions were made on palate, thus forming a full-thickness palatal flap and possible full view of the bone defect of approximately 2 cm in diameter [Figure 4]. A titanium mesh measuring 3 cm × 3 cm, 0.1 mm thick with four screws 1.5 mm × 5 mm was installed in the place [Figure 5], covered with palatine flap and sutured with 4-0 polyglactin 910. The denudated place was covered with surgical cement (PerioBond - Dentsply®- Petrópolis/RJ - Brasil) and removed after 2 weeks. Postoperatively, patient received antibiotics, anti-inflammatory, analgesic and nasal decongestant. We observed proper surgical site healing after the surgical cement was removed, without infection and/or dehiscence. The patient remained under follow-up of 06 months, when complete closure of OAF and tissue repair was noted [Figures 6 and 7].

Bottom Line: The oroantral fistula (OAF) is an epithelialized communication between the oral cavity and the maxillary sinus.In most of the cases, this communication occurs after molars and premolars extractions, but other factors may be cause of the communication, such as trauma.This article demonstrates an alternative surgical technique illustrated with a case report in which we perform the surgical treatment of OAF with palatal flap rotation combined with the use of titanium mesh in a victim of gunshot projectile wound in oral cavity.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Hospital Regional do Agreste, Caruaru, Pernambuco, Brazil.

ABSTRACT
The oroantral fistula (OAF) is an epithelialized communication between the oral cavity and the maxillary sinus. In most of the cases, this communication occurs after molars and premolars extractions, but other factors may be cause of the communication, such as trauma. This article demonstrates an alternative surgical technique illustrated with a case report in which we perform the surgical treatment of OAF with palatal flap rotation combined with the use of titanium mesh in a victim of gunshot projectile wound in oral cavity.

No MeSH data available.


Related in: MedlinePlus