Advantage

• This flap is useful in teeth with a generous mesiodistal width, affording an adequate surgical field

The most common flap procedures may be categorized into local flaps, distant flaps, and grafting. The flaps involving rotating or advancing soft tissues include buccal flap, palatal flap, submucosal tissue flap, and buccal fat pad and tongue flap [26]. The procedures utilizing buccal mucoperiosteal flap for closure include straight-advancement flap, rotation-advancement flap, transverse flap, and sliding flap techniques, and those utilizing palatal mucoperiosteum include straightadvancement flap, rotational advancement flap, hinged flap, and island flap procedures [26]. Double-layer closure utilizing local tissues includes the combination of inversion and rotational advancement flaps, double overlapping hinged flaps, double island flaps, and superimposition of reverse palatal and buccal flaps. However, the studies over the last 50 years point out the lack of consensus for a uniformly

Here we illustrate the most common flaps used for closure of oroantral communication/fistula: the buccal flap and the palatal pedicle flap techniques.

It has been described [14, 29] the use of a buccal flap with a thin layer of buccinator muscle to close an oroantral defect. Later, [30] reported a buccal sliding flap technique, which is still in use, as a tool to close small to medium size (<1 cm) lateral or mid-alveolar fistulas, located either laterally or in the middle of the alveolar process. Krompotie and Bagatin [13] reported the immediate closure of an oroantral communication by a rotating gingiva-vestibular flap. This technique can also be employed for closing oroantral fistulas. It is a modification of a vestibular flap in order to avoid lowering of the vestibular sulcus, an event that takes place normally when using vestibular flaps. Two vertical release incisions are made to provide a flap with dimensions suitable for closure of the antral communication (**Figure 34**). Incision removal of the epithelial lining of the palatal mucosa behind the communication might also be required. The flap with a trapezoidal shape consists of both epithelium and connective tissues and is positioned over the defect using

• It is possibly utilized in cases of severly resorbed alvealr ridge, and the fistula is

mattress sutures from the buccal flap to the palatal mucosa.

located in a more mesial area [31]

• Loss of vestibular depth buccally

*The buccal advancement flap is used to close OAC (arrow).*

successful procedure [28].

*Flap Techniques in Dentoalveolar Surgery DOI: http://dx.doi.org/10.5772/intechopen.91165*

**8.2 Buccal advancement flap**

Advantage

Limitation

**Figure 34.**

**223**

Limitations

