Comparative Analysis of Buccal Fat Pad vs Buccal Advancement Flap in Cases of Oro-Antral Communication – A Retrospective Study

Abstract

Introduction: Oroantral communication (OAC) is a common complication following maxillary posterior tooth extractions and surgical interventions involving the maxillary sinus. If untreated, it may progress to oroantral fistula (OAF) and chronic sinusitis. Among several surgical options, buccal fat pad (BFP) and buccal advancement flap (BAF) are the most widely used. This study retrospectively compared their clinical outcomes in OAC management.

Materials and Methods: A retrospective review of 40 patients treated for OAC over one year was performed. Patients were divided into two groups: BFP (n=20) and BAF (n=20). Parameters assessed included, complete closure rate, mean healing time(days), dehiscence (flap opening), recurrence. Statistical analysis was done using chi-square and Student’s t-test, with p<0.05 considered significant.

Results: Both techniques achieved high closure rates. The BFP group showed fewer cases of wound dehiscence, faster mucosal epithelialization, and no recurrence, with an overall success rate of 95%. The BAF group achieved 90% closure but was associated with more postoperative discomfort and reduction in vestibular depth. No major complications were reported in either group.

Conclusion: Both BFP and BAF are effective for OAC closure. BFP is preferable for larger defects, while BAF remains suitable for smaller ones. A tailored, case-specific approach ensures optimal outcomes.