title: Composite three-layer closure of oral antral communication with 10 months follow-up-a case study.
abstract: OBJECTIVE
  We propose a 3-layer composite closure technique for an oral antral communication (OAC) while avoiding secondary donor site morbidity.
  
  
  METHODS
  A patient had developed a 1-cm OAC after extraction of right maxillary first molar. The patient subsequently developed acute maxillary sinusitis. The patient was taken to the operating room, and a Caldwell-Luc procedure was performed. The bony window from the Caldwell-Luc was "press fit" over the bony OAC defect. Soft tissue closure was then achieved with a buccal fat pad flap and a buccal mucosal advancement flap. The patient was examined on postoperative day 5 and 1, 2, 3, 6, and 10 months postoperatively.
  
  
  RESULTS
  The acute sinusitis had resolved. The soft tissue closure was successful. The bone graft remained intact, prevented sinus pneumatization, and restored continuity to the floor of the maxillary sinus.
  
  
  CONCLUSIONS
  The presented technique for 3-layer closure of OACs allows for the stability of a double-layer closure of OAC with the added benefit of bone grafting from single operative site, achieving stable oral antral closure, bone grafting, and the avoidance of secondary donor site morbidity.
authors: Resident, Department of Oral and Maxillofacial Surgery, Woodhull Medical and Mental Health Center, Brooklyn, NY. Electronic address: rjw2119@columbia.edu.
authors: Robert J
authors: RJ
authors: Weinstock
authors: Resident, Department of Oral and Maxillofacial Surgery, Woodhull Medical and Mental Health Center, Brooklyn, NY.
authors: Levon
authors: L
authors: Nikoyan
authors: Chairman, Department of Dentistry and Oral and Maxillofacial Surgery; Director, Oral and Maxillofacial Surgery Residency Training Program, Brooklyn Hospital Center, Brooklyn, NY; Assistant Director, Department of Dentistry and Oral and Maxillofacial Surgery, Woodhull Medical and Mental Health Center, Brooklyn, NY; and Clinical Professor, Department of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, New York, NY.
authors: Harry
authors: H
authors: Dym
mesh_terms: D000273:Adipose Tissue / Q000601:surgery; D000328:Adult; D016025:Bone Transplantation; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D015523:Maxillary Sinusitis / Q000601:surgery; D009061:Mouth Mucosa / Q000601:surgery; D019647:Oral Surgical Procedures / Q000379:methods*; D009957:Oroantral Fistula / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D014081:Tooth Extraction / Q000009:adverse effects