Comparison of palatal rotational flap with buccal advancement flap for the treatment of oroantral fistula

Abstract

Objective: To compared outcome of palatal rotational flap with buccal advancement flap for the treatment of oroantral fistula.

Methodology: This Randomized controlled clinical trial was performed in outpatient Department of Oral and Maxillofacial Surgery Unit, Punjab dental hospital, Lahore from June 2013 to December 2013. One hundred and twenty patients were included which were divided into two groups; Group A (buccal advancement flap) and Group B (palatal rotational flap). Both procedures were performed under local anesthesia. Oral penicillin and nasal decongestant were prescribed after the procedure.

Results: The mean±SD ages were 35.10±8.56 years of group A and 35.73±9.40 years in group B. There were 40 males and 20 females in group A, while in group B there were 42 males and 18 females. Male to female ratios were 2:1 and 2.4:1. Fifty two patients (86.6%) have success and 8 patients (13.4%) have no success in group A while in group B, 56 patients (93.3%) have success rate and 4 patients (6.7%) have no success rate. Statistically, there was no significant difference (P>0.05). There is no statistical difference in the outcome of oroantral fistula for both local and distant flaps.

Conclusion: Treatment options for OAC/OAF include various soft tissue flaps with or without bone grafting and the best method should be emphasized upon to achieve proper closure. Buccal advancement flaps are best suited for small fistulas while palatal rotational flap or a combination of the two gives best results for large oroantral fistulas.