Bony press-fit closure of oro-antral fistulas: a technique for pre-sinus lift repair and secondary closure.

PURPOSE: To evaluate the use of intra-oral bone grafts for closing chronic oro-antral fistulas (OAFs), for providing a sound basis for subsequent conventional sinus lifting and for preserving the teeth adjacent to OAFs.

PATIENTS AND

METHODS

Twenty-one patients with oro-antral fistulas of variable origin were treated with monocortical bone blocks harvested from the retromolar or interforaminal regions of the mandible. The preoperative treatment, the surgical procedure for both hard and soft tissue closure, and the postoperative management are reviewed in detail.

RESULTS

Press-fit closure for repair of the bony sinus floor was sufficient in 17 patients. Four of them needed additional internal fixation. In all 21 patients adequate closure of the fistulas was obtained, although 3 patients (14.3%) developed wound dehiscences at the grafted sites, which healed by secondary intention. Meanwhile, 3 patients underwent successful sinus lifting.

CONCLUSION

The use of monocortical bone grafts harvested at intra-oral donor sites is a safe and easy technique for repairing defects of the maxilla, especially OAFs in need of secondary closure. It provides a sound basis for subsequent conventional sinus lifting and preserves the teeth adjacent to OAFs.