Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up
Identifieur interne : 001D71 ( Pmc/Corpus ); précédent : 001D70; suivant : 001D72Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up
Auteurs : David Pe Arrocha-Oltra ; Rocio Alonso-González ; Hilario Pellicer-Chover ; Amparo Aloy-Pr Sper ; María Pe Arrocha-DiagoSource :
- Journal of Clinical and Experimental Dentistry [ 1989-5488 ] ; 2015.
Abstract
The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction. A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient.
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DOI: 10.4317/jced.51741
PubMed: 25810829
PubMed Central: 4368005
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up</title><author><name sortKey="Pe Arrocha Oltra, David" sort="Pe Arrocha Oltra, David" uniqKey="Pe Arrocha Oltra D" first="David" last="Pe Arrocha-Oltra">David Pe Arrocha-Oltra</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Alonso Gonzalez, Rocio" sort="Alonso Gonzalez, Rocio" uniqKey="Alonso Gonzalez R" first="Rocio" last="Alonso-González">Rocio Alonso-González</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Pellicer Chover, Hilario" sort="Pellicer Chover, Hilario" uniqKey="Pellicer Chover H" first="Hilario" last="Pellicer-Chover">Hilario Pellicer-Chover</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Aloy Pr Sper, Amparo" sort="Aloy Pr Sper, Amparo" uniqKey="Aloy Pr Sper A" first="Amparo" last="Aloy-Pr Sper">Amparo Aloy-Pr Sper</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Pe Arrocha Diago, Maria" sort="Pe Arrocha Diago, Maria" uniqKey="Pe Arrocha Diago M" first="María" last="Pe Arrocha-Diago">María Pe Arrocha-Diago</name><affiliation><nlm:aff id="A2">Full Professor of Oral Surgery. Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25810829</idno><idno type="pmc">4368005</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4368005</idno><idno type="RBID">PMC:4368005</idno><idno type="doi">10.4317/jced.51741</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001D71</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001D71</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up</title><author><name sortKey="Pe Arrocha Oltra, David" sort="Pe Arrocha Oltra, David" uniqKey="Pe Arrocha Oltra D" first="David" last="Pe Arrocha-Oltra">David Pe Arrocha-Oltra</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Alonso Gonzalez, Rocio" sort="Alonso Gonzalez, Rocio" uniqKey="Alonso Gonzalez R" first="Rocio" last="Alonso-González">Rocio Alonso-González</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Pellicer Chover, Hilario" sort="Pellicer Chover, Hilario" uniqKey="Pellicer Chover H" first="Hilario" last="Pellicer-Chover">Hilario Pellicer-Chover</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Aloy Pr Sper, Amparo" sort="Aloy Pr Sper, Amparo" uniqKey="Aloy Pr Sper A" first="Amparo" last="Aloy-Pr Sper">Amparo Aloy-Pr Sper</name><affiliation><nlm:aff id="A1">Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author><author><name sortKey="Pe Arrocha Diago, Maria" sort="Pe Arrocha Diago, Maria" uniqKey="Pe Arrocha Diago M" first="María" last="Pe Arrocha-Diago">María Pe Arrocha-Diago</name><affiliation><nlm:aff id="A2">Full Professor of Oral Surgery. Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Clinical and Experimental Dentistry</title><idno type="eISSN">1989-5488</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction.
A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient.
</p><p><bold> Key words:</bold>Bichat fat pad, buccal fat pad, zygomatic implants, oroantral communication.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Cawood, Ji" uniqKey="Cawood J">JI Cawood</name></author><author><name sortKey="Howell, Ra" uniqKey="Howell R">RA Howell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chrcanovic, Br" uniqKey="Chrcanovic B">BR Chrcanovic</name></author><author><name sortKey="Abreu, Mh" uniqKey="Abreu M">MH Abreu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Becktor, Jp" uniqKey="Becktor J">JP Becktor</name></author><author><name sortKey="Isaksson, S" uniqKey="Isaksson S">S Isaksson</name></author><author><name sortKey="Abrahamsson, P" uniqKey="Abrahamsson P">P Abrahamsson</name></author><author><name sortKey="Sennerby, L" uniqKey="Sennerby L">L Sennerby</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abuabara, A" uniqKey="Abuabara A">A Abuabara</name></author><author><name sortKey="Cortez, Al" uniqKey="Cortez A">AL Cortez</name></author><author><name sortKey="Passeri, La" uniqKey="Passeri L">LA Passeri</name></author><author><name sortKey="De Moraes, M" uniqKey="De Moraes M">M de Moraes</name></author><author><name sortKey="Moreira, Rw" uniqKey="Moreira R">RW Moreira</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Egyedi, P" uniqKey="Egyedi P">P Egyedi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Poeschl, Pw" uniqKey="Poeschl P">PW Poeschl</name></author><author><name sortKey="Baumann, A" uniqKey="Baumann A">A Baumann</name></author><author><name sortKey="Russmueller, G" uniqKey="Russmueller G">G Russmueller</name></author><author><name sortKey="Poeschl, E" uniqKey="Poeschl E">E Poeschl</name></author><author><name sortKey="Klug, C" uniqKey="Klug C">C Klug</name></author><author><name sortKey="Ewers, R" uniqKey="Ewers R">R Ewers</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Moraes, Ej" uniqKey="De Moraes E">EJ de Moraes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abad Gallegos, M" uniqKey="Abad Gallegos M">M Abad-Gallegos</name></author><author><name sortKey="Figueiredo, R" uniqKey="Figueiredo R">R Figueiredo</name></author><author><name sortKey="Rodriguez Baeza, A" uniqKey="Rodriguez Baeza A">A Rodríguez-Baeza</name></author><author><name sortKey="Gay Escoda, C" uniqKey="Gay Escoda C">C Gay-Escoda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dolanmaz, D" uniqKey="Dolanmaz D">D Dolanmaz</name></author><author><name sortKey="Tuz, H" uniqKey="Tuz H">H Tuz</name></author><author><name sortKey="Bayraktar, S" uniqKey="Bayraktar S">S Bayraktar</name></author><author><name sortKey="Metin, M" uniqKey="Metin M">M Metin</name></author><author><name sortKey="Erdem, E" uniqKey="Erdem E">E Erdem</name></author><author><name sortKey="Baykul, T" uniqKey="Baykul T">T Baykul</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singh, J" uniqKey="Singh J">J Singh</name></author><author><name sortKey="Prasad, K" uniqKey="Prasad K">K Prasad</name></author><author><name sortKey="Lalitha, Rm" uniqKey="Lalitha R">RM Lalitha</name></author><author><name sortKey="Ranganath, K" uniqKey="Ranganath K">K Ranganath</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hernando, J" uniqKey="Hernando J">J Hernando</name></author><author><name sortKey="Gallego, L" uniqKey="Gallego L">L Gallego</name></author><author><name sortKey="Junquera, L" uniqKey="Junquera L">L Junquera</name></author><author><name sortKey="Villarreal, P" uniqKey="Villarreal P">P Villarreal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Heydecke, G" uniqKey="Heydecke G">G Heydecke</name></author><author><name sortKey="Boudrias, P" uniqKey="Boudrias P">P Boudrias</name></author><author><name sortKey="Awad, Ma" uniqKey="Awad M">MA Awad</name></author><author><name sortKey="De Albuquerque, Rf" uniqKey="De Albuquerque R">RF De Albuquerque</name></author><author><name sortKey="Lund, Jp" uniqKey="Lund J">JP Lund</name></author><author><name sortKey="Feine, Js" uniqKey="Feine J">JS Feine</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pjetursson, Be" uniqKey="Pjetursson B">BE Pjetursson</name></author><author><name sortKey="Karoussis, I" uniqKey="Karoussis I">I Karoussis</name></author><author><name sortKey="Burgin, W" uniqKey="Burgin W">W Bürgin</name></author><author><name sortKey="Br Gger, U" uniqKey="Br Gger U">U Brägger</name></author><author><name sortKey="Lang, Np" uniqKey="Lang N">NP Lang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aparicio, C" uniqKey="Aparicio C">C Aparicio</name></author><author><name sortKey="Ouazzani, W" uniqKey="Ouazzani W">W Ouazzani</name></author><author><name sortKey="Garcia, R" uniqKey="Garcia R">R Garcia</name></author><author><name sortKey="Arevalo, X" uniqKey="Arevalo X">X Arevalo</name></author><author><name sortKey="Muela, R" uniqKey="Muela R">R Muela</name></author><author><name sortKey="Fortes, V" uniqKey="Fortes V">V Fortes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Farre Guasch, E" uniqKey="Farre Guasch E">E Farré-Guasch</name></author><author><name sortKey="Marti Page, C" uniqKey="Marti Page C">C Martí-Pagè</name></author><author><name sortKey="Hernadez Alfaro, F" uniqKey="Hernadez Alfaro F">F Hernádez-Alfaro</name></author><author><name sortKey="Klein Nulend, J" uniqKey="Klein Nulend J">J Klein-Nulend</name></author><author><name sortKey="Casals, N" uniqKey="Casals N">N Casals</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Exp Dent</journal-id><journal-id journal-id-type="iso-abbrev">J Clin Exp Dent</journal-id><journal-id journal-id-type="publisher-id">Medicina Oral S.L.</journal-id><journal-title-group><journal-title>Journal of Clinical and Experimental Dentistry</journal-title></journal-title-group><issn pub-type="epub">1989-5488</issn><publisher><publisher-name>Medicina Oral S.L.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25810829</article-id><article-id pub-id-type="pmc">4368005</article-id><article-id pub-id-type="publisher-id">51741</article-id><article-id pub-id-type="doi">10.4317/jced.51741</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject><subj-group><subject>Oral Surgery</subject></subj-group></subj-group></article-categories><title-group><article-title>Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Peñarrocha-Oltra</surname><given-names>David</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Alonso-González</surname><given-names>Rocio</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Pellicer-Chover</surname><given-names>Hilario</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Aloy-Prósper</surname><given-names>Amparo</given-names></name><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Peñarrocha-Diago</surname><given-names>María</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Master in Oral Surgery and Implant Dentistry. Collaborating Professor of Oral Surgery, Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</aff><aff id="A2"><label>2</label>Full Professor of Oral Surgery. Stomatology Department. Faculty of Medicine and Dentistry. University of Valencia, Spain</aff><author-notes><corresp> Clínicas odontológicas
Gascó Oliag 1
46021- Valencia, Spain
, E-mail: <email>Maria.Penarrocha@uv.es</email></corresp></author-notes><pub-date pub-type="epub"><day>1</day><month>2</month><year>2015</year></pub-date><pub-date pub-type="collection"><month>2</month><year>2015</year></pub-date><volume>7</volume><issue>1</issue><fpage>e159</fpage><lpage>e162</lpage><history><date date-type="accepted"><day>12</day><month>9</month><year>2014</year></date><date date-type="received"><day>27</day><month>5</month><year>2014</year></date></history><permissions><copyright-statement>Copyright: © 2015 Medicina Oral S.L.</copyright-statement><copyright-year>2015</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.5/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The aim of this study was to assess the use of buccal fat pad (BFP) technique as an option to close oroantral communications (OAC) after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction.
A 64-year-old woman presented recurrent sinusitis and permanent oroantral communication caused by bilateral failed zygomatic implants, 3 years after prosthetic loading. Zygomatic implants were removed previous antibiotic treatment and the BFP flap technique was used to treat the OAC and maxillary defect. The degree of patient satisfaction after treatment was assessed through a visual analogue scale (VAS). At 6-months follow-up, patient showed complete healing and good function and the results in terms of phonetics, aesthetics and chewing were highly rated by the patient.
</p><p><bold> Key words:</bold>Bichat fat pad, buccal fat pad, zygomatic implants, oroantral communication.</p></abstract></article-meta></front><body><sec sec-type="intro"><title>Introduction</title><p>Several techniques have been described to treat the atrophic maxilla (Cawood and Howell classes IV or V) (<xref rid="B1" ref-type="bibr">1</xref>), including zygomatic implants (ZIs) (<xref rid="B2" ref-type="bibr">2</xref>). Although ZIs seemed to have high survival rates, complications are common (<xref rid="B2" ref-type="bibr">2</xref>), as permanent oroantral fistula formation (<xref rid="B3" ref-type="bibr">3</xref>) that may be responsible for recurrent sinusitis and therefore, indication for ZI removal (<xref rid="B3" ref-type="bibr">3</xref>). Numerous techniques for oroantral communication (OAC) closure, including grafts and flaps of proximity or distance, such as pedicled Bichat´s ball (BFP) have been described (<xref rid="B4" ref-type="bibr">4</xref>).</p><p>Since in 1977 Egyedi (<xref rid="B5" ref-type="bibr">5</xref>) described the technique of closure oroantral fistula by using pedicled Bichat´s ball, it has become a procedure widely used in regenerative oral surgery. In the past four decades, several authors have resorted to using the Bichat´s ball to close oroantral communications of diverse etiology (<xref rid="B5" ref-type="bibr">5</xref>-<xref rid="B9" ref-type="bibr">9</xref>) either acute, chronic or recurring character (<xref rid="B9" ref-type="bibr">9</xref>). The reported advantages of its use have been the easy availability of the flap, and the large blood supply that the recipient bed receives, resulting in high success rates (<xref rid="B6" ref-type="bibr">6</xref>,<xref rid="B10" ref-type="bibr">10</xref>). Complications of this technique are rare (<xref rid="B4" ref-type="bibr">4</xref>,<xref rid="B11" ref-type="bibr">11</xref>), resulting in most cases aesthetic, phonetic and chewing acceptable results.</p><p>A clinical case is reported in which the BFP technique was used to OAC closure after removing failed zygomatic implants in a patient with a severely resorbed maxilla, and to determine the degree of patient satisfaction.</p></sec><sec><title>Case Report</title><p>A 64-year-old woman referred discomfort in the maxillary area. Clinical history examination revealed that the atrophic maxilla was rehabilited four years before, by 3 conventional implants implants (Phibo® TSA, Phibo Dental Solutions, Impladent, Senmenat, Barcelona, España), two zygomatic implants (Nobel Biocare®, Goteborg, Sweden) and fixed full-arch implant-supported prosthesis. After three years of loading, bilateral sinusitis have been diagnosed (the patient had rhinorrhea, cacosmia, and pain in malar area) and treated through Cadwell-Luc technique and antibiotic treatment (Proflox 400mg, 1 compressed, once daily during 7 days).</p><p>One year after sinusitis treatment, recurrent sinusitis was diagnosed. During clinical examination and questionnaire, the patient reported inaccurate pain at bilateral sinus level of varying intensity. Patient had slight tenderness of cheekbones. Colour and texture of the gum was correct, but at probing depth, the zygomatic implants showed palatal oroantral communication (Fig.<xref ref-type="fig" rid="F1">1</xref>). A radiographic examination (panoramic radiography and computerized tomography [CT], Fig. <xref ref-type="fig" rid="F2">2</xref>a-b) was performed. Oroantral communication accompanied by bilateral recurrent sinusitis was diagnosed.</p><p><fig id="F1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Oroantral communication in relation to zygomatic implants (ZIs) in a severely resorbed maxilla, after 3 years of prosthetic loading. Detail of probing depth verifying the permanent bilateral OAC before ZIs extraction. </p></caption><graphic xlink:href="jced-7-e159-g001"></graphic></fig></p><p><fig id="F2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>A)Panoramic radiography and B) computerized tomography (TC) showing bilateral maxillary sinus occupation (sinusitis) secondary to permanent oroantral communication due to resorption of the thin palatal bone corresponding to ZIs. C) Control orthopantomography 6 months after surgery.</p></caption><graphic xlink:href="jced-7-e159-g002"></graphic></fig></p><p>Amoxicillin 500 mg/125 clavulanic acid, 3 times during 10 days, and Ibuprofen (600 mg, 3 times daily) were prescribed for the treatment of sinusitis and pain. Patient was revaluated one month later. Due to OAC permanence and recurrent sinusitis history, removal of both ZIs was decided. OAC closure through buccal fat pad flat technique was planned as it is described in the literature.</p><p>-BFP technique</p><p>Once recurrent sinusitis was resolved, ZIs were removed (Fig. <xref ref-type="fig" rid="F3">3</xref>a-e). Operation was performed by an experienced surgeon (MP). After local anesthesia with articaine and infiltrative 4% and adrenaline 1:100.000 (Inibsa ®, Lliça Vall, Barcelona, Spain), ZIs were removed and a trapezoidal mucoperiosteal flap was obtained by two divergent incisions, one on each side of the location of the defect, extending to the bottom of the vestibule. The COA defect was exposed (Fig. <xref ref-type="fig" rid="F3">3</xref>c). BFP was harvested by performing a 1-cm crestal incision starting at the tuberosity behind the zygomatic buttress. Then, a blunt clamp was introduced to the temporomandibular angle in order to separate the fibers of the buccinator muscle. By a slight pressure on the cheek, the buccal extension of Bichat´s ball was exposed. The necessary amount of buccal fat was pedicled to entirely cover the defect area (Fig. <xref ref-type="fig" rid="F3">3</xref>d). BFP was covered as much as possible by the mucoperiosteal flap and it was sutured without tension (Fig. <xref ref-type="fig" rid="F3">3</xref>e). Analgesics and antibiotic prophylaxis was prescribed (Amoxicillin 500mg + clavulanic acid 125mg every 8 hours for 7 days). A soft diet was recommended for 1 week and the patient was instructed to avoid brushing and trauma on the surgical sites. Sutures were removed 1 week postoperatively. Conventional denture was confectioned and was worn provisionally in the healing periods.</p><p><fig id="F3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Surgical treatment. Detail of left ZIs removal and surgical OAC closure through buccal fat pad flap technique. A) Intraoral clinical picture prior to failed ZIs extraction. B) Left ZI removal. C) Mucoperiosteal flap elevation showing orosinusal communication. D) Pedicled buccal fat covering the maxillary defect area. E) Mucoperiosteal flap replacement and suture. F) Maxillary gingiva healing 6 months after surgery.
</p></caption><graphic xlink:href="jced-7-e159-g003"></graphic></fig></p><p>-Follow-up and patient satisfaction </p><p>The patient was screened in a program of routine check-ups (one week, 1 and 6 months after surgery). No postoperative complications were collected on successive controls. An overdenture over 3 residuals implants was performed as a new prosthesis design. At six months of follow-up after surgery, patient showed complete healing and the oroantral communication had been resolved (Fig. <xref ref-type="fig" rid="F2">2</xref>c-3f).</p><p>At 6-months follow-up, patient satisfaction was assessed in order to determine overall satisfaction regarding treatment and new prosthesis design. A ten-cm visual analogue scale (VAS) (range 1-10) was used to estimate patient satisfaction. General satisfaction with the implant-retained prosthesis and specific satisfaction regarding aesthetics, phonetics and mastication were assessed. The patient was asked to draw a vertical line at a point on the horizontal line which best represented his response (<xref rid="B12" ref-type="bibr">12</xref>,<xref rid="B13" ref-type="bibr">13</xref>). The best valued parameter by patient was the phonetic [9], followed by chewing [8] and aesthetics [7]; the mean overall satisfaction was 8 out of 10.</p></sec><sec sec-type="discussion"><title>Discussion</title><p>Literature provides high ZIs survival rates; however, this type of implants is not free of complications (<xref rid="B2" ref-type="bibr">2</xref>,<xref rid="B14" ref-type="bibr">14</xref>). Some authors have reported ZIs removals because of recurrent sinusitis which were not resolved with antibiotics and sinus rinses (<xref rid="B3" ref-type="bibr">3</xref>). In some cases, this sinus infection is secondary to oroantral fistulae formation, which is speculated to appear due to deficient osseointegration of the coronal part of the ZI, thereby creating the communication between the oral and sinus cavities (<xref rid="B3" ref-type="bibr">3</xref>,<xref rid="B14" ref-type="bibr">14</xref>).</p><p>Resorption of the thin palatal bone rapidly leads to oroantral fistula followed by implant loss (<xref rid="B3" ref-type="bibr">3</xref>), and it seems likely to occur at any time after implant placement (<xref rid="B2" ref-type="bibr">2</xref>). In the present case report, ZIs extraction was decided due to recurrent sinusitis history and persistent oroantral communication (OAC) 3 years after prosthesis loading.</p><p>One important question in the case reported was the OAC management. Bilateral buccal fat pad (BFP) flap technique to solve the maxillary defect was decided.</p><p>The BFP is an adipose mass located in the deep facial spaces. It has been widely used to reconstruct oral and maxillofacial defects because of its physical and biological properties, e.g.: its anatomical location closest to the recipient bed, vascularization, ease of production and management, and the presence of stem cells (<xref rid="B9" ref-type="bibr">9</xref>,<xref rid="B10" ref-type="bibr">10</xref>,<xref rid="B15" ref-type="bibr">15</xref>). Some researchers have recommended the BFP flap as a first option for closure of larger OACs (<xref rid="B4" ref-type="bibr">4</xref>,<xref rid="B6" ref-type="bibr">6</xref>,<xref rid="B7" ref-type="bibr">7</xref>).</p><p>The most critical factor for the success of the buccal fat pad seems to be the communication´s size (<xref rid="B10" ref-type="bibr">10</xref>); Abuabara <italic>et al.</italic> (<xref rid="B4" ref-type="bibr">4</xref>) re-commended the use of the Bichat´s ball in large communications (> 5 mm in diameter), in which the use of buccal flap could compromise its blood supply and/or loss of vestibular sulcus depth. However, limiting the amount of pedicled Bichat´s ball is recommended because large defects require greater traction of the pedicle, and it may increase postoperative complications such as aesthetic depression of the cheek (<xref rid="B6" ref-type="bibr">6</xref>). Most common complications in the literature were the persistence of the fistula and limitation of mouth opening, especially after reconstructing oroantral communications accompanied by large bone defects (<xref rid="B6" ref-type="bibr">6</xref>,<xref rid="B8" ref-type="bibr">8</xref>). However, most studies have shown good results with BFP´s technique to close oroantral communications and treat maxillary bone defects (<xref rid="B4" ref-type="bibr">4</xref>,<xref rid="B6" ref-type="bibr">6</xref>-<xref rid="B9" ref-type="bibr">9</xref>,<xref rid="B11" ref-type="bibr">11</xref>). The advantages of BFP graft include the easy access to the anatomic region for excision, and the large blood supply that the recipient bed receives, yielding high success rates in OAC closure (<xref rid="B6" ref-type="bibr">6</xref>,<xref rid="B10" ref-type="bibr">10</xref>). To our knowledge, this is the first BFP´s case reporting patient satisfaction and assessing the changes after surgery regarding to aesthetics, phonetics and mastication.</p><p>In this case report, the use of BFP was a good treatment option to close oroantral communications caused after removing failed zygomatic dental implants and neither recurrences nor complications were found. At six months of follow-up after surgery, patient showed complete healing and good function. The results in terms of phonetics, aesthetics and chewing were highly rated by the patient.</p></sec></body><back><ref-list><ref id="B1"><label>1</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cawood</surname><given-names>JI</given-names></name><name><surname>Howell</surname><given-names>RA</given-names></name></person-group><article-title>A classification of the edentulous jaws</article-title><source>Int J Oral Maxillofac Surg</source><year>1988</year><volume>17</volume><fpage>232</fpage><lpage>6</lpage><pub-id pub-id-type="pmid">3139793</pub-id></element-citation></ref><ref id="B2"><label>2</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chrcanovic</surname><given-names>BR</given-names></name><name><surname>Abreu</surname><given-names>MH</given-names></name></person-group><article-title>Survival and complications of zygomatic implants: a systematic review</article-title><source>Oral Maxillofac Surg</source><year>2013</year><volume>17</volume><fpage>81</fpage><lpage>93</lpage><pub-id pub-id-type="pmid">22562293</pub-id></element-citation></ref><ref id="B3"><label>3</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Becktor</surname><given-names>JP</given-names></name><name><surname>Isaksson</surname><given-names>S</given-names></name><name><surname>Abrahamsson</surname><given-names>P</given-names></name><name><surname>Sennerby</surname><given-names>L</given-names></name></person-group><article-title>Evaluation of 31 zygomatic implants and 74 regular dental implants used in 16 patients for prosthetic reconstruction of the atrophic maxilla with cross-arch fixed bridges</article-title><source>Clin Implant Dent Relat Res</source><year>2005</year><volume>7</volume><fpage>159</fpage><lpage>65</lpage><pub-id pub-id-type="pmid">16219246</pub-id></element-citation></ref><ref id="B4"><label>4</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Abuabara</surname><given-names>A</given-names></name><name><surname>Cortez</surname><given-names>AL</given-names></name><name><surname>Passeri</surname><given-names>LA</given-names></name><name><surname>de Moraes</surname><given-names>M</given-names></name><name><surname>Moreira</surname><given-names>RW</given-names></name></person-group><article-title>Evaluation of different treatments for oroantral/oronasal communications: experience of 112 cases</article-title><source>Int J Oral Maxillofac Surg</source><year>2006</year><volume>35</volume><fpage>155</fpage><lpage>8</lpage><pub-id pub-id-type="pmid">15955666</pub-id></element-citation></ref><ref id="B5"><label>5</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Egyedi</surname><given-names>P</given-names></name></person-group><article-title>Utilization of the buccal fat pad for closure of oro-antral and/or oro-nasal communications</article-title><source>J Maxillofac Surg</source><year>1977</year><volume>5</volume><fpage>241</fpage><lpage>4</lpage><pub-id pub-id-type="pmid">338848</pub-id></element-citation></ref><ref id="B6"><label>6</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Poeschl</surname><given-names>PW</given-names></name><name><surname>Baumann</surname><given-names>A</given-names></name><name><surname>Russmueller</surname><given-names>G</given-names></name><name><surname>Poeschl</surname><given-names>E</given-names></name><name><surname>Klug</surname><given-names>C</given-names></name><name><surname>Ewers</surname><given-names>R</given-names></name></person-group><article-title>Closure of oroantral communications with Bichat's buccal fat pad</article-title><source>J Oral Maxillofac Surg</source><year>2009</year><volume>67</volume><fpage>1460</fpage><lpage>6</lpage><pub-id pub-id-type="pmid">19531418</pub-id></element-citation></ref><ref id="B7"><label>7</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>de Moraes</surname><given-names>EJ</given-names></name></person-group><article-title>Closure of oroantral communication with buccal fat pad flap in zygomatic implant surgery: a case report</article-title><source>Int J Oral Maxillofac Implants</source><year>2008</year><volume>23</volume><fpage>143</fpage><lpage>6</lpage><pub-id pub-id-type="pmid">18416426</pub-id></element-citation></ref><ref id="B8"><label>8</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Abad-Gallegos</surname><given-names>M</given-names></name><name><surname>Figueiredo</surname><given-names>R</given-names></name><name><surname>Rodríguez-Baeza</surname><given-names>A</given-names></name><name><surname>Gay-Escoda</surname><given-names>C</given-names></name></person-group><article-title>Use of Bichat's buccal fat pad for the sealing of orosinusal communications. A presentation of 8 cases</article-title><source>Med Oral Patol Oral Cir Bucal</source><year>2011</year><volume>16</volume><fpage>e215</fpage><lpage>9</lpage><pub-id pub-id-type="pmid">20711145</pub-id></element-citation></ref><ref id="B9"><label>9</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Dolanmaz</surname><given-names>D</given-names></name><name><surname>Tuz</surname><given-names>H</given-names></name><name><surname>Bayraktar</surname><given-names>S</given-names></name><name><surname>Metin</surname><given-names>M</given-names></name><name><surname>Erdem</surname><given-names>E</given-names></name><name><surname>Baykul</surname><given-names>T</given-names></name></person-group><article-title>Use of pedicled buccal fat pad in the closure of oroantral communication: analysis of 75 cases</article-title><source>Quintessence Int</source><year>2004</year><volume>35</volume><fpage>241</fpage><lpage>6</lpage><pub-id pub-id-type="pmid">15119684</pub-id></element-citation></ref><ref id="B10"><label>10</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Singh</surname><given-names>J</given-names></name><name><surname>Prasad</surname><given-names>K</given-names></name><name><surname>Lalitha</surname><given-names>RM</given-names></name><name><surname>Ranganath</surname><given-names>K</given-names></name></person-group><article-title>Buccal pad of fat and its applications in oral and maxillofacial surgery: a review of published literature (February) 2004 to (July) 2009</article-title><source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source><year>2010</year><volume>110</volume><fpage>698</fpage><lpage>705</lpage><pub-id pub-id-type="pmid">20580275</pub-id></element-citation></ref><ref id="B11"><label>11</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hernando</surname><given-names>J</given-names></name><name><surname>Gallego</surname><given-names>L</given-names></name><name><surname>Junquera</surname><given-names>L</given-names></name><name><surname>Villarreal</surname><given-names>P</given-names></name></person-group><article-title>Oroantral communications. A retrospective analysis</article-title><source>Med Oral Patol Oral Cir Bucal</source><year>2010</year><volume>15</volume><fpage>e499</fpage><lpage>503</lpage><pub-id pub-id-type="pmid">20038901</pub-id></element-citation></ref><ref id="B12"><label>12</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Heydecke</surname><given-names>G</given-names></name><name><surname>Boudrias</surname><given-names>P</given-names></name><name><surname>Awad</surname><given-names>MA</given-names></name><name><surname>De Albuquerque</surname><given-names>RF</given-names></name><name><surname>Lund</surname><given-names>JP</given-names></name><name><surname>Feine</surname><given-names>JS</given-names></name></person-group><article-title>Within-subject comparisons of maxillary fixed and removable implant prostheses: Patient satisfaction and choice of prosthesis</article-title><source>Clin Oral Implants Res</source><year>2003</year><volume>14</volume><fpage>125</fpage><lpage>30</lpage><pub-id pub-id-type="pmid">12562375</pub-id></element-citation></ref><ref id="B13"><label>13</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pjetursson</surname><given-names>BE</given-names></name><name><surname>Karoussis</surname><given-names>I</given-names></name><name><surname>Bürgin</surname><given-names>W</given-names></name><name><surname>Brägger</surname><given-names>U</given-names></name><name><surname>Lang</surname><given-names>NP</given-names></name></person-group><article-title>Patients' satisfaction following implant therapy. A 10-year prospective cohort study</article-title><source>Clin Oral Implants Res</source><year>2005</year><volume>16</volume><fpage>185</fpage><lpage>93</lpage><pub-id pub-id-type="pmid">15777328</pub-id></element-citation></ref><ref id="B14"><label>14</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Aparicio</surname><given-names>C</given-names></name><name><surname>Ouazzani</surname><given-names>W</given-names></name><name><surname>Garcia</surname><given-names>R</given-names></name><name><surname>Arevalo</surname><given-names>X</given-names></name><name><surname>Muela</surname><given-names>R</given-names></name><name><surname>Fortes</surname><given-names>V</given-names></name></person-group><article-title>A prospective clinical study on titanium implants in the zygomatic arch for prosthetic rehabilitation of the atrophic edentulous maxilla with a follow-up of 6 months to 5 years</article-title><source>Clin Implant Dent Relat Res</source><year>2006</year><volume>8</volume><fpage>114</fpage><lpage>22</lpage><pub-id pub-id-type="pmid">16919019</pub-id></element-citation></ref><ref id="B15"><label>15</label><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Farré-Guasch</surname><given-names>E</given-names></name><name><surname>Martí-Pagè</surname><given-names>C</given-names></name><name><surname>Hernádez-Alfaro</surname><given-names>F</given-names></name><name><surname>Klein-Nulend</surname><given-names>J</given-names></name><name><surname>Casals</surname><given-names>N</given-names></name></person-group><article-title>Buccal fat pad, an oral access source of human adipose stem cells with potential for osteochondral tissue engineering: an in vitro study</article-title><source>Tissue Eng Part C Methods</source><year>2010</year><volume>16</volume><fpage>1083</fpage><lpage>94</lpage><pub-id pub-id-type="pmid">20078198</pub-id></element-citation></ref></ref-list></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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