Closure of Oroantral Communications With Bichat's Buccal Fat Pad

Purpose: The aim of the present study was to evaluate the use of the pedicled buccal fat pad for the closure of oroantral communications (OACs) and to describe our experience with this surgical procedure. Patients and Methods: A retrospective review of 161 patients treated at the University Hospital for Cranio-Maxillofacial and Oral Surgery in Vienna, Austria, from 2000 to 2005, with the diagnosis of an OAC was performed. All defects were closed by application of a buccal fat pad. Data were obtained from chart review, a compiled database, and clinical follow-up and included the location of the defect, the cause of the OAC, the modality of anesthesia, intraoperative complications, any complications during the process of wound healing, and any late adverse effects. Results: The buccal fat pad for closure of an OAC was successfully used in 161 patients at our department. In 12 patients (7.5%), the closure of the OAC was insufficient, and a second operation was necessary. Excluding all severe and complicating cases such as tumor-related defects or previously treated cases, the over-all success rate for closure of the OAC was nearly 98%. No late complications occurred, and all patients were free of pain or any limitations after the 6-month follow-up period. Conclusions: According to the recommendations and anatomic limitations reported in published studies and discussed in the present report, the application of the buccal fat pad is a safe and reliable procedure for closing an OAC. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:1460-1466, 2009