Modified Submucosal Connective Tissue Flap Technique for Oroantral Fistula Closure
Mustafa Ayhan1, Zeynep Afra Akbıyık Az1
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Univesity, Istanbul, Turkey.
Background:
Oroantral fistulas are challenging complications that often require surgical intervention for successful closure and long-term healing.
Purpose:
To present a modified submucosal connective tissue flap technique that enhances closure stability and healing predictability in oroantral fistulas.
Methods:
Following excision of the fistula and sinus debridement, a standard buccal advancement flap was elevated. A subepithelial connective tissue graft was harvested from the palatal mucosa using a partial-thickness dissection and stabilized using resorbable sutures anchored to bone perforations. The overlying buccal flap was then advanced and sutured to complete a bilayered closure.
Results:
The technique allowed tension-free closure with improved flap stability and reduced donorsite morbidity. Postoperative healing was uneventful, and complete mucosal regeneration was observed within one month.
Conclusions:
This bilayered closure technique, combining mechanical anchorage of a palatal graft with a buccal advancement flap, provides a reliable and predictable solution for oroantral fistula closure, particularly in edentulous or anatomically compromised cases.
