IM0410

I user report _ oroantral communications Fig. 1_OAC in region 26. Fig. 2_Closure of the perforation with oxydized cellulose. Fig. 3_The extruded bone graft sub- stitute is flatted at its front. _Abstract Methods for the closure of oroantral communica- tionsthatoccuroccasionallyaftertoothextractionare invasiveandlaborious.Here,weassessedasimpleand efficient technique to close such perforations in nine patients. The oroantral communication at the bottom of the extraction socket was covered with oxygenized, degradable cellulose and the coronal two thirds of the socket were filled with in-situ hardening polylactide- coated -tricalcium phosphate ( -TCP). An airtight, stable barrier could be established in all cases, and wound healing was uneventful. The novel procedure was minimally invasive and patient-friendly. Soft tis- suecoveredthematerialaftertwoweeks,andthebio- logicalwidthwasreestablishedaftertwomonths.Hard and soft tissue structures were preserved. The bone substitutehasbeenpartiallyreplacedbyalveolarbone at the end point of this case-cohort study. A complete regenerationofthealveolarbonecanthusbeexpected. _Background Oroantral communications (OACs) may occur after the extraction of the upper first molars and—less fre- quently—after extraction of premolars or second and third molars (Ehrl 1980; Amaratunga 1986). Left un- treated, this may result in the formation of oroantral fistulae and chronic infection of the sinus cavities (Amaratunga 1986). An immediate and complete clo- sure of the communication is thus indicated if the si- nus cavities are not already infected (Kraut and Smith 2000;Greensteinetal.2008). Frequently, soft tissue flaps are used to close the communications,withgoodresults(Lambrecht2000). However,flapmobilizationinvolvesslittingofthemu- cosa and the periost and is rather invasive, post-oper- ative swelling and pain are thus common (Gacic et al. 2009). Furthermore, the procedure leads to displace- mentoftissueandscarring.Asaconsequence,reloca- tion procedures become necessary in most cases. Oroantral communication closure with tissue trans- plants and membranes represent an alternative to the flap-based methods. These surgical methods can be combinedwithaugmentativemeasurestopreservethe dimensions of the alveolar ridge (Becker et al. 1987; Watzek 2008). Membrane-based techniques and soft tissuetransplantationsarecharacterizedbygoodalve- olarhard-undsofttissuepreservationandthusarebe- comingmorepopular(Schwarzetal.2006;Cardaropoli and Cardaropoli 2008; Fickl et al. 2008). Nevertheless, The use of polylactide- coated -TCP Closure of oroantral communications Authors_Dr Stefan Neumeyer, Dr Stefanie Neumeyer-Wühr, Germany 32 I implants4_2010 Fig. 2 Fig. 3Fig. 1