Dentaltown August 2017 - 67

Follow-up progress

Conclusion

At the two-week follow-up appointment, the patient reported an uneventful
postoperative course with little pain or
discomfort. His clinical exam revealed good
wound healing with apparent achievement of
closure/repair of the large chronic oral/antral
fistula (Figs. 15 and 16), despite his continued
heavy smoking.
At six weeks postoperatively, the patient
was seen again for follow-up. The incision
site was noted to be closed and mucosalized,
without any evidence of the fistula. Again,
he was symptom- free, and no longer experiencing fluid leakage (Figs. 17 and 18).
The patient will return to undergo
pre-prosthetic surgery in the form of mandibular alveoloplasty, lingual tori removal
and a maxillary vestibuloplasty procedure.
Eight to 12 weeks later, a prosthodontist
colleague will take impressions to begin
fabrication of his definitive removable
complete dental prosthesis.

Buccal fat-pad reconstruction techniques have been successfully used in defects
extending up to nearly 4cm in size. Larger
defects, however, are prone to dehiscence and
may require additional flaps. The greatest
disadvantage of the buccal fat-pad flap is
that it may create a lack in vestibular depth,
which may complicate the fabrication and
limit the mucosal retention of a removable
complete dental prosthesis.
The buccal fat pad is an extremely
versatile anatomic structure for oral and
maxillofacial reconstruction because of its
relative ease to access and dissect, its robust
blood supply, its quick mucosalization
potential, and its ability to reach to distant
defects in the maxilla. Many surgeons prefer
this technique over rotational palatal flap
techniques because the procedure is quick,
consistently reliable, cost-effective and
well-accepted from a patient comfort and
recovery standpoint. ■

Fig. 15: Two weeks after procedure.

Fig. 16: Corrected mirror view
two weeks postoperatively.
Residual sutures removed.

Fig. 17: Six weeks after procedure.

Fig. 18: Corrected mirror view
six weeks postoperatively.
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dentaltown.com \\ AUGUST 2017

67



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Table of Contents for the Digital Edition of Dentaltown August 2017

Dentaltown August 2017 - Intro
Dentaltown August 2017 - Cover1
Dentaltown August 2017 - Cover2
Dentaltown August 2017 - 1
Dentaltown August 2017 - 2
Dentaltown August 2017 - 3
Dentaltown August 2017 - 4
Dentaltown August 2017 - 5
Dentaltown August 2017 - 6
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Dentaltown August 2017 - 8
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