A novel approach to closure of oroantral communication by a modified buccal mucosal flap: A prospective clinical study

Objectives: The buccal mucosal flap is a good option for covering small and medium sized defects of oroantral communication (OAC) due to similar tissue characteristics, easy accessibility, tension free primary closure, unlikely dehiscence, maintenance of buccal sulcus depth, thoroughly vascularised flap, and easy implementation. Background: This prospective clinical study done on 30 patients with OAC, closure with single layer pedicled buccal mucosal flap and donor site coverage with buccal fat pad. Methods: In this technique pedicled buccal mucosal flap is dissected containing submucosal tissue, few fibers of buccinator at the flap base which provide strength and increased vascularity. The portion of flap covering the OAC is purely mucosal flap. Detailed clinical examination done to patients postoperatively for 30 days evaluates complications like wound dehiscence and flap necrosis at recipient site, fistula recurrence, sinusitis, scarring at donor site, reduced and difficulty in mouth opening. Results: Flap thickness of pedicled buccal mucosal flap is less, a single layer reconstruction with tissue histologically similar to the original tissue ensures better functional results and adequate barrier. It is simple to perform and well tolerated by the patients. Conclusion: Flap perfusion depends on pedicle width for arterial circulation and venous drainage; oral mucosa has rich blood supply, a random pattern flap contains partial thickness of the buccinator muscle can survive.