ISPUB.COM The Internet Journal of Dental Science Volume 8 Number 1 1 of 8 A Comparison between Submucosal Connective Tissue Palatal Flap and Conventional Pedicle Palatal Flap for the Closure of Oroantral Fistulae F Yabroudi, A Dannan Citation F Yabroudi, A Dannan. A Comparison between Submucosal Connective Tissue Palatal Flap and Conventional Pedicle Palatal Flap for the Closure of Oroantral Fistulae. The Internet Journal of Dental Science. 2008 Volume 8 Number 1. Abstract Background and Aim: Oroantral communication and subsequent formation of oroantral fistula is a common complication of dental extraction and/or other oro-facial surgeries. Many surgical procedures have been used for the treatment of oroantral fistula, and it is believed that long term successful closure of oroantral fistula depends on the technique used, the size and the location of the defect. The aim of this study is to evaluate the success of the submucosal connective tissue palatal flap technique compared to the conventional pedicled palatal flap technique in the closure of oroantral fistula.Materials and Methods: Ten patients suffering from oroantral fistula were recruited in the study, and they were divided into two groups. The first group was treated with the conventional pedicled palatal flap technique, and the second group was treated with the submucosal connective tissue flap technique. Suitable post-operative care and observation in both groups were achieved.Results: It has been shown that all fistulae were closed successfully in both groups. There was no discomfort and no burning sensation in the second group. They all showed relatively fast healing. Interestingly, patients in the second group needed fewer amounts of post- operative analgesics than in the first group.Conclusion: Both types of flap techniques provided sufficient and successful closure of oroantral fistula. However, submucosal connective tissue palatal flap seems to be preferable for fistula closure because it overcomes the disadvantages of the full thickness palatal flap. Compared with the conventional palatal flap, submucosal connective tissue palatal flap technique may appear to be more difficult in terms of flap manipulation. The surgical experience plays an important role at this level. INTRODUCTION Oroantral fistula (OAF) is the communication between the maxillary sinus cavity and the oral cavity through a perforation in the sinus wall. The term oroantral communication comprises two pathological conditions; the acute oroantral perforation and the chronic communication ‘‘fistula’‘ (1). Oroantral communication and subsequent formation of OAF is a common complication of dental extraction. Owing to its anatomical location and intimate relationship with the teeth, the maxillary sinus occupies an important place in oral surgery. From a small cavity at birth, the maxillary sinus starts to enlarge during the third month of fetal life and usually reaches maximum development around the eighteenth year. Its volume is approximately 20-25ml in a normal adult. The removal of the first upper molar is the most common etiological factor which may lead to OAF (2). Some pathological conditions that might also cause oroantral communication are: removal of tumors or cysts of the palate, cases of noma, syphilitic gumma, leprosy, and lishmaniasis (3). An OAF usually needs 7 days to epithelize and become a chronic fistulous tract (4). Long term successful closure of OAF depends on the technique used, the size and the location of the defect (2). Many surgical procedures have been used for the treatment of OAF (3) such as: Buccal flaps Pedicle tongue flap Combined buccal and reverse palatal flap Pedicle buccal fat pad graft Palatal pedicle flaps