One stage operation of large oroantral fistula closure, sinus lifting for dental implant installation Bu-Kyu Lee Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, Ulsan University Abstract Bone grafts at the maxillary sinus are often required after closure of an oroantral fistula (OAF) to allow for subsequent implant installation. The present report describes a single procedure that provides large OAF closure and bone grafting at the involved sinus. This technique involves sinus mucosal lifting via elevating the sinus membrane, which is recovered as a continuous layer by combining the residual sinus membranes with a flipped part of the oral mucosa around the OAF. This technique involves sinus mucosal lifting via elevating the sinus membrane, which is recovered as a continuous layer by combining the residual sinus membranes with a flipped part of the oral mucosa around the OAF. Autogenous bone from the Ileum was grafted into the prepared sinus space, and the oral side of the graft was covered by a rotated palatal flap. This technique was used to treat 3 patients who had large OAFs in the atrophied posterior maxillay region due to previous multiple implant failures after sinus lifting. The treatment was successful in all cases. This technique appears to be suitable for large OAFs where implants are subsequently required. Keywords; bone graft, dental implant, OAF, oroantral fistula, sinus lifting 26 Implantology Vol. 12, No. 3 2008
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original article (a) (b) Fig 5. Corticocancellous block bone으로 다리를 만들고, particulated marrow bone particle로주변을 채워 이식한다. 4. 구개회전피판을 이용한 구강부의 폐쇄 cle의 혈류에 영향을 주지 않도록 하면서 주의 깊게 피판을 회 OAF부위에 이식된 골편의 구강내 노출된 부위를 덮기 위 전하여 재위치 시킨 후 주변의 점막과 봉합을 하였다. Donor 하여, 전층(Full thickness)의 회전 구개유경 피판(rotation- site의 denuded portion은 합성 collagen(terudermis, al palatal pedicled flap)을 이용하였다(figure 1, 6). pedi- Terumo, Japan)으로 덮어주어 점막의 치유를 촉진 시켰다 Fig 6. 구개유경 피판을 회전시켜 이식부의 구강부를 덮어 Fig 7. 술 후 resin splint를 장착한 모습. 준 모습. 30 Implantology Vol. 12, No. 3 2008
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original article 32 Implantology Vol. 12, No. 3 2008
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