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Oliva S, Lorusso F, Scarano A, D’Amario M, Murmura G. The Treatment and Management of Oroantral Communications and Fistulas: A Systematic Review and Network Metanalysis. Dent J (Basel) 2024; 12:147. [PMID: 38786545 PMCID: PMC11120370 DOI: 10.3390/dj12050147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/17/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES The aim of this work was to systematically review and carry out a statistical metanalysis to identify the best treatment for close oroantral communications and fistulas and to avoid the risk of recurrence. MATERIALS AND METHODS An electronic search was conducted on the MEDLINE database (Pubmed), Scopus, and Google scholar using the following keywords: "oro antral communication (OAC)" OR "oro antral fistula (OAF)" OR "antro-oral communication" OR "communication between maxillary sinus and oral cavity" OR "oro-sinusal communication" OR "oro-sinusal fistula" OR "sinus communication" OR "sinus fistula" OR "antral communication" AND "treatment" OR "management" OR "surgical treatment" OR "surgical interventions". This work was performed in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). After article screening, 9 RCTs (randomized controlled trials), comparing two or more techniques, were included in this review. RESULTS A statistically significant difference was detected in favor of the buccal fat pad compared to the buccal advancement flap and palatal rotational flap. CONCLUSIONS With the limitations of this study, the buccal fat pad showed the best results in terms of communication closure and reducing the risk of relapse.
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Affiliation(s)
- Stefano Oliva
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (F.L.); (A.S.); (G.M.)
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (F.L.); (A.S.); (G.M.)
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (F.L.); (A.S.); (G.M.)
| | - Maurizio D’Amario
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Giovanna Murmura
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (F.L.); (A.S.); (G.M.)
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Adamska P, Pylińska-Dąbrowska D, Stasiak M, Kaczoruk-Wieremczuk M, Kozłowska E, Zedler A, Studniarek M. Treatment of Odontogenic Maxillary Sinusitis with the Use of Growth Factors in Advanced Platelet-Rich Fibrin for Immediate Closure of Oro-Antral Communication: A Case Report. Int J Mol Sci 2024; 25:4339. [PMID: 38673924 PMCID: PMC11049874 DOI: 10.3390/ijms25084339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
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.
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Affiliation(s)
- Paulina Adamska
- Division of Oral Surgery, Faculty of Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland;
| | - Dorota Pylińska-Dąbrowska
- Department of Dental Prosthetics, Faculty of Medicine, Medical University of Gdańsk, 18 Orzeszkowej Street, 80-204 Gdańsk, Poland;
| | - Marcin Stasiak
- Division of Orthodontics, Faculty of Medicine, Medical University of Gdańsk, Aleja Zwycięstwa 42c, 80-210 Gdańsk, Poland;
| | - Magdalena Kaczoruk-Wieremczuk
- Individual Specialist Oral Surgery Practice Magdalena Kaczoruk-Wieremczuk, 41/31 Władysława Wysockiego Street, 17-100 Bielsk Podlaski, Poland;
| | - Ewa Kozłowska
- Institute of Manufacturing and Materials Technology, Faculty of Mechanical Engineering and Ship Technology, Gdańsk University of Technology, 11/12 Gabriela Narutowicza Street, 80-233 Gdańsk, Poland;
| | - Adam Zedler
- Division of Oral Surgery, Faculty of Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland;
| | - Michał Studniarek
- Department of Radiology, Faculty of Medicine, Medical University of Gdańsk, 17 Smoluchowskiego Street, 80-210 Gdańsk, Poland;
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Nelke K, Morawska A, Błaszczyk B, Janeczek M, Pasicka E, Łukaszewski M, Żak K, Dobrzyński M. Anatomical and Surgical Implications of the Usage of Bichat Fat Pad in Oroantral Communication, Maxillary, Palatal, and Related Surgeries-Narrative Review. J Clin Med 2023; 12:4909. [PMID: 37568311 PMCID: PMC10419993 DOI: 10.3390/jcm12154909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
The buccal fat pad, also called the Bichat's fat pad (BFP), is an encapsulated fat mass located in the cheek. This type of specialized fat mass can be used both as a pedicular or free graft in various surgeries and approaches. Due to its easy access from the oral cavity approach, it is commonly used for oroantral and palatal fistula closure. The knowledge of its anatomy and surrounding tissues plays a role in its mobilization and suturing onto the desired defect in the palatal or maxillary region. The BFP is mostly associated with the primary approach used for a fistula or bone surgery. Alternatively, the procedure can be performed with a single approach incision, which does not compromise the appearance or the function of the operating or adjacent areas. The most important inclusion criteria for BFP usage and surgical limitations are highlighted. The BFP is used for multiple purposes in reconstructive and oncology surgery and also has its use in esthetic and facial contouring procedures. The amount, volume, and shape of the BFP are mostly associated with the scope of their usage. The aim of the following narrative review is to present the surgical and anatomical implications of fat pads in maxillary and palatal surgeries.
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Affiliation(s)
- Kamil Nelke
- Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland
- Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland;
| | - Alicja Morawska
- Department of Pediatric Dentistry and Preclinical Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland; (A.M.); (M.D.)
| | - Bartłomiej Błaszczyk
- Student Scientific Circle of Experimental Dentistry and Biomaterial Research, Faculty of Dentistry, Wroclaw Medical University, Bujwida 44, 50-345 Wrocław, Poland
| | - Maciej Janeczek
- Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland; (M.J.); (E.P.)
| | - Edyta Pasicka
- Department of Biostructure and Animal Physiology, Wrocław University of Environmental and Life Sciences, Kożuchowska 1, 51-631 Wrocław, Poland; (M.J.); (E.P.)
| | - Marceli Łukaszewski
- Department of Anaesthesiology and Intensive Care, Sokołowski Hospital, Sokołowskiego 4, 58-309 Wałbrzych, Poland;
| | - Krzysztof Żak
- Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland;
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wrocław Medical University, Krakowska 26, 50-425 Wrocław, Poland; (A.M.); (M.D.)
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Singh V. Covid-19 Pandemic: An Impending Threat to Aesthetic Surgery Procedures. World J Plast Surg 2023; 12:98-99. [PMID: 37220577 PMCID: PMC10200080 DOI: 10.52547/wjps.12.1.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/09/2023] [Indexed: 05/25/2023] Open
Affiliation(s)
- Veena Singh
- Burns & Plastic Surgery, All India Institute of Plastic Surgery, Patna, Bihar, India
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Bereczki-Temistocle DL, Gurzu S, Ioan I, Vlad GM, Beresescu G, Ormenisan A. Successful Closure of an Oro-Antral Communication, after Three Previously Failed Attempts, Using Bichat Fat Pad Flap: A Case Report. World J Plast Surg 2023; 12:90-94. [PMID: 37220572 PMCID: PMC10200079 DOI: 10.52547/wjps.12.1.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 04/30/2023] [Indexed: 05/25/2023] Open
Abstract
An oro-antral communication represents an abnormal connection between the oral cavity and the maxillary sinus. It occurs most often after tooth extractions, improper implant placement or incorrect management of the sinus lifts. Surgical repair is challenging and most practitioners usually choose the buccal advancement flap, the palatal flap and in some cases the buccal fat pad flap to close the defect. We present a 43 year-old female of a large oro-antral communication and associated chronic sinusitis which was succesfully manged by surgery. Previous interventions including 2 buccal advancement flaps, and a double layer closure using Collagen membrane and buccal advancement flap were unsuccesful. The stepwise intervention consisted on the complete cleaning of the sinus, using the Caldwell Luc technique, followed by the closure of the oro-antral communication using Bichat fat pad flap. The particular aspect was the proper integration of the buccal fat pad flap, after 3 failed attempts, without dehiscence or any other complications. The buccal fat pad flap can be succesfully used for closure of lage oro-antral communications, even when previous methods have failed and local tissue is of poor quality.
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Affiliation(s)
- Despina Luciana Bereczki-Temistocle
- Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
- IOSUD ´´G. E. Palade´´ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Simona Gurzu
- Department of Morphopatology George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Ioan Ioan
- Department of Morphopatology George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Golu Mihai Vlad
- Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
- IOSUD ´´G. E. Palade´´ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Gabriela Beresescu
- Department of Tooth and Arch Morphology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Alina Ormenisan
- Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
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