The Clinical Outcomes of Free Buccal Fat Pad Graft for Closure of Oroantral Communications Compared to Pedicled Buccal Fat Pad Flap: A Randomised Clinical Trial

ABSTRACT Aim This study aimed to describe an additional application of the free buccal fat pad graft (FBFPG), assess its effectiveness in closing oroantral communication (OAC), and compare its impact on postoperative edema with that of the pedicled buccal fat pad flap (PBFPF). Materials and Methods The sample consisted of 22 patients who developed OAC following tooth extraction. The patients were randomly divided into two groups: the study group, consisting of 11 patients treated with FBFPG, and the control group, consisting of 11 patients treated with PBFPF. All patients were assessed on the first, third, and seventh postoperative days to measure edema. Success of closure was evaluated on the 7th, 14th, and 45th postoperative days. Both groups were followed up for 3 months to monitor for any recurrence of OAC. Results The success rate of closure in the control group (PBFPF) was 100%, whereas the success rate in the study group (FBFPG) was 81.8%, with two cases failing to close. There was no statistically significant difference between the two groups in terms of closure success ( χ 2 = 2.2, p = 0.138). In terms of edema, the FBFPG group exhibited mild edema, while the PBFPF group showed edema ranging from mild to moderate, with a clinically and statistically significant difference between the two groups, especially on the first and third postoperative days ( p < 0.001 for both). Edema gradually decreased and nearly disappeared by the seventh day. No statistically significant difference was observed between the two techniques on the seventh day ( p = 0.094). Conclusion Within the limitations of this study, the use of FBFPG is an effective technique for the closure of OACs, demonstrating a good success rate compared to PBFPF without causing any pathological reactions within the maxillary sinus. Additionally, FBFPG is a safe, simple technique that causes less trauma than PBFPF.