Closure of a Mouth-Sinus Communication with a Buccal Advancement Flap
This mouth-sinus hole (Oro-Antral Communication) was created when the patient had his Upper Left 6 (UL6) / Upper Left 1st Molar removed
(the patient also had all his other teeth removed at the same time).
After the swelling and soreness of the Full Dental Clearance had started to settle, the patient was
referred back to the hospital department as he had noticed that when he drank, fluid came out of
his nose.
Diagram showing the first stages of the closure of an OAC using a Buccal Advancement Flap.

The OAC is excised and incisions made into the buccal mucosa to create a flap that will cover the OAC.
Diagram showing the next stage of the closure of an OAC using a Buccal Advancement Flap.
Diagram showing the final stage of the closure of an OAC using a Buccal Advancement Flap.

The Buccal Advancement Flap has been brought palatally and sutured into place.
Last Updated 21st March 2020
The OAC has been excised and the buccal advancement flap has been raised in preparation to suture it to the palatal mucosa.
Useful Articles:

BJOMS 1986.  Oro-Antral Fistulae - A Study of Clinical, Radiological & Treatment Aspects

Acta Stomat Croat 2002.  Treatment of Oro-Antral Fistula

Austral Dent J 2003.  Non-Surgical Management of an Oro-Antral Fistula in a Patient with HIV Infection

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003.  Use of third molar transplantation for closure of the oroantral communication after
tooth extraction.  A report of 2 cases

Swiss Med Wkly 2003.  The reconstruction of oral defects with buccal fat pad

Dental Update 2004.  The Buccal Fat Pad in the Closure of Oro-Antral Communications: An Illustrated Guide

Turk J Med Sci 2004.  Buccal Corticotomy for Closure of Oro-Antral Openings - Case Report

JOMS 2005. Bony Press-Fit Closure of Oro-Antral Fistulas - A Technique for Pre-Sinus Lift Repair and Secondary Closure

W Ind Med J 2005.  A New Surgical Management for Oro-Antral Communication.  The Resorbable Guided Tissue Regeneration Memebrane
- Bone Substitute Sandwich Technique

Intl J Oral Maxillofac Surg 2006.  Evaluation of different treatments for oroantral & oronasal communications - experience of 112 cases

BJOMS 2007.  Incidence & predictive factors for perforation of the maxillary antrum in operations to remove upper wisdom teeth.
Prospective multi-centre study

JOMS 2009.  Closure of Oroantral Communications with Bichat’s Buccal Fat Pad

JSCR 2010.  Oro-Antral Fistula from Bisphosphonates-Induced Osteonecrosis of the Jaw

J Int Oral Health 2010.  Treatment of Oro-Antral Fistula using Palatal Flap.  A Case Report & Technical Note

J Oral Maxillofac Surg 2010.  Closure of Oroantral Communications - A Review of the Literature

JOMS 2010.  Closure of Oroantral Communications Using Biodegradable Polyurethane Foam - A Feasibility Study

Med Oral Patol Oral Cir Bucal. 2010.  Oroantral Communications.  A Retrospective Analysis

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010.  Buccal Pad of Fat & its Applications in Oral & Maxillofacial Surgery - A Review of
Published Literature 2004 to 2009

Pakistan Oral & Dent J 2010.  Treatment of Oroantral Fistula – A Study

BDJ 2011.  Oro-Antral Fistulae & Fractured Tuberosities

BJOMS 2011. Technical Note.  Closure of Oro-Antral Fistula using Auricular Cartilage. A New Method to Repair an Oro-Antral Fistula

Eur Soc Radiology 2011.  Oroantral Fistulas.  CT Evaluation with Dentascan software

Int J Dent Clinics 2011.  Use of Palatal Rotation Flap in the Closure of Oroantral Communication

J Maxillofac Oral Surg 2012.  Surgical Management of Oro-Antral Communications Using Resorbable GTR Membrane and FDMB Sandwich
Technique - A Clinical Study

JUMDC 2012.  Case Report.  Use of Buccal Fat Pad Oro-Antral Fistula Repair

Open Dent J 2012.  Surgical Options In Oroantral Fistula Treatment

Otolaryngology 2012.  Reliability of 2 Surgical Methods for Oro-Antral Communication Closure.  A Clinical Study of 20 Patients

JOMS 2013.  Treatment of Oro-Antral Fistulas using Bony Press-Fit Technique

J Clin Exp Dent 2015.  Alternative Surgical Management of Oroantral Fistula using Auricular Cartilage

Acta Otorrinolaringol Esp 2016.  Case Study.  Odontogenic Sinusitis, Oro-antral Fistula & Surgical Repair by Bichat’s Fat Pad - Literature

Annals of Otolaryngology & Rhinology 2016.  Etiology & Management of Oro-Antral Fistula

Cochrane Database of Systematic Reviews 2016.  Interventions for Treating Oro-Antral Communications & Fistulae due to Dental
Procedures (Review)

Intech 2016.  Management of the Oroantral Fistula

Intl J Adv Res 2016.  Double layered flap for closure of recurrent oroantral fistula using buccal fat pad & palatal pedicled flap – a case report

Int J Sci Study 2017.  Closure of Oroantral Communication Using Buccal Advancement Flap - A Case Report

World J Plast Surg 2017.  Management of Oro-antral Communication & Fistula - Various Surgical Options

PowerPoint Presentation on OAC's