IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 10 Ver. XII (October. 2016), PP 24-28 www.iosrjournals.org DOI: 10.9790/0853-1510122428 www.iosrjournals.org 24 | Page Buccal Fat Pad Graft (BFPG): An Ideal Graft for Closure of Oro-Antralfistula -Our Experiences Dr. Rubia Siddiqui 1 , Dr. Md. Kalim Ansari 2 , Dr. S. S.Ahmed 3 JR III 1, Assistant professor 2, Professor 3 Department of Oral and Maxillofacial Surgery, Dr. Z.A. Dental College, Aligarh Muslim University, Aligarh, India Abstract: Oro antral fistula (OAF) is a common condition encountered in day to day practice. There are various etiological factors and different treatments options available. We performed a clinical study using BFPG in different cases of OAF and found it a versatile technique for different sizes of fistula. Our experiences on this aspect have been presented in this paper. Keywords: Oroantral fistula, Maxillary sinus, Buccal fat pad graft, I. Introduction An oroantral communication (OAC) is an pathological connection between the oral cavity and a maxillary sinus (1).OAC of size more than 3 mm if not treated can lead to formation of oroantral fistula (2).Etiological factors that leads to formation of OAC are simple or surgical extraction of maxillary teeth, cysts and tumors, or infectious processes (3). A number of treatment modalities are available in literature for closure of oroantral fistula like palatal flap, buccal advancement flap, tongue flap, or buccal fat pad graft. Use of BFP to close OAF was first described by Egyedi in 1977(4).In 1986 Tideman et al studied the use of BFPG to treat buccal and maxillary defects and showed good results. In this paper we report the successful closure of OAC with the BFPG in a series of 13 patients. II. Materials & Methods This study included 13 patients of OAF who reported to Department of oral and maxillofacial surgery, Dr.Z.A.Dental College & Hospital, AMU Aligarh, India. Patients with uncontrolled systemic disorders like Diabetes mellitus, hypertension etc. were excluded .The study procedure was explained to all the patients and their consent were obtained. Preoperatively all patients were prepared with lavage of sinus with normal saline and prescribed antibiotics (Amoxycillin 500mg TDS and Metronidazole400mg TDS) along with nasal decongestant drops (xylometazoline)& antihistaminic tablet (levocetrizine 10mg OD)for seven days to make them free of their sinusitis .The absence of sinusitis was confirmed with findings of no discharge and negative culture report in all cases. Complete detail of the study patients is given in table 1. III. Surgical Technique All the cases were operated under local anesthesia using 2% lignocaine & 1: 80,000 adrenaline. A margin of 2mm tissue around OAF was excised by giving a circular incision and complete epithelial tract of fistula was removed.To expose BFP graft two vertical releasingincisions, one anterior and one posterior to OAF extending into the vestibule were given. The trapezoidal mucoperiosteal flap was reflected and a horizontal incision of the periosteum was given at the level of buccal sulcus. With the help of curved mosquito artery blunt dissection was done to expose BFP and then it was gently advanced into the defect and sutured without tension with palatal mucosa. Preoperative medications along with 0.12% chlorhexidine digluconide mouth wash were continued for 1 week postoperatively. Patients were instructed to take soft diet and avoid nose blowing for 2 weeks postoperatively. Follow up visits were scheduled for a period of 3 month to observe any complication.