THE USE OF BIOGLASS IN CLOSURE OF RECURRENT OROANTRAL FISTULA
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Oroantra/ fistula is a commonly encountered clinical problem. As the diameter of the bony deficiency and elevated air pressure on one or both sides of the wound are main factors involved in healing of OAF it was tried in this study to investigate the effects of the use of Bioglass for the treatment of recurrent oroantral fistula after surgical closure. The study was conducted on 14 patients having a history suggesting oroantrat ftstula after tooth extraction with recurrence after previous surgical closure. A coronal CT scan was performed to assess the maxillary sinus and to evaluate the fistula. The Caldwell-Luc operation was performed endoscopically for the existing sinus pathology. After the treatment of sinus pathology, a palatal, buccal or buccopatatal flap was created. Scar tissue and osteitis were removed from the fistulous tract. The track was then closed using apiece of Bioglass plate. The piece of the used bioglass was sculptured using a sharp scalpel or a diamond burr until it becomes nearly fitted to the track then it was placed inside the track. If there is any space between the piece of the Bioglass and the outer wall of the track. The mucoperios teal palatalflap is rotated across over the defect. After 3 months the fistula closed by new bone of nearly the same density of the adjacent bone in 12 patients. Postoperative radiographs showed clear sinuses in 12 patients with mildly thickened mucosa at the floor and adjacent parts of the medial and lateral walls. In 2 patients the operation was considered as failed. One of those two patients was diabetic. In the diabetic patient, there was extrusion of the bioglass after 7 days from the wound which healed partially.