This communication often paves the way for chronic sinusitis, nasal regurgitation, foul taste, and compromised oral function.
Traditional surgical approaches—buccal flaps, palatal flaps, buccal fat pad grafts—have offered solutions, but usually at a cost: loss of vestibular depth, donor-site morbidity, tension on the flap, or altered oral architecture.
In “A Pedicled Buccal Periosteal Flap for the Closure of Oro-Antral Fistula”, Ibrahim, Gharieb, and Sheta introduce a novel approach that seeks to combine the best of both worlds: a closure that is tension-free, preserves the native vestibular depth, and harnesses the regenerative potential of the periosteum.
Their study of 10 patients demonstrates promising outcomes—complete healing in nearly all cases, improved maxillary sinus function, and minimal anatomical disruption.
Crucially, they document that the vestibular depth remains essentially unchanged, a key concern for patients wearing dentures or those concerned about oral aesthetics and prosthetic fit.
This technique—a deep periosteal flap, pedicled, turned over the bony defect and sutured to palatal tissues, with the superficial mucosal layer also managed—offers an elegant, biologically favorable option in the surgeon’s armamentarium.
It underscores how understanding tissue layers and vascular supply can lead to repair strategies that heal not just effectively, but gracefully.
Why It Matters
Function & Comfort: Less tension, preserved vestibular depth, reducing complications for prosthetic users.
Regeneration: The periosteum is rich in progenitor/stem cells, supports angiogenesis, and may enhance healing without grafts or synthetic materials.
Simplicity & Safety: The technique can be done under local anesthesia, with fewer drawbacks compared to more complex flaps or remote grafts.
💬 To the global dental community: if you’re involved in oral surgery, prosthodontics, implantology, or maxillofacial practice, this article offers valuable insights into a novel flap option.
I invite you to read the full article in PDF to explore the methodology, clinical photos, outcomes, and consider whether the pedicled buccal periosteal flap might be suitable in your practice setting.
