Comparison of the efficacy between the free buccal fat pad and the pedicled buccal fat pad in management of maxillary sinus perforation

Abstract

Background and aim: Oroantral communication (OAC) indicates to the connection between the maxillary sinus and the oral cavity. The extraction of the posterior upper teeth is one of the main causes of it. There are many methods used to close it in order to avoid its development to an oroantral fistula. The use of the free buccal fat pad in the immediate closure of the OACs is a new technique was used in this study. This study aimed to evaluate the efficacy of the free buccal fat pad (FBFP) and the pedicled buccal fat pad (PBFP) in closure of the OACs and comparing the pain caused by both techniques.

  Materials and methods: 14 patients aged 24-58 with OAC resulting from a dental extraction. The sample was divided into two groups, the first is the test group was treated with FBFP and the control group was treated with PBFP. The success of complete closure was evaluated after 45 days and one week after the surgery to assess the pain caused by the two techniques. The clinical follow up was lasted after 3 months to ensure that there was no relapse in cases of success or other complications.

  Results: The success rate in the closure using the FBFP was 71.4% while it was 100% in the PBFP, the pain rate was mild to moderate in the two research groups with a statistically significant difference between the two groups on the first and third days after surgery, it was higher in the control group.

  Conclusions: Within the limits of this study we conclude that the FBFP was able to close small and medium OACs formed after dental extraction and has a good success rate and the pain resulting from it is relatively less than (PBFP), but it requires great care from the patient and full commitment from him to instructions and recommendations after surgery. With good surgical experience by the surgeon.