What is the best approach for closing an oro-antral fistula resulting from a first molar extraction?

The closure of an oro-antral fistula, particularly one resulting from the extraction of a maxillary first molar, is critical for preventing complications such as chronic sinusitis and ensuring proper healing. The choice of utilizing a buccal advancement flap is effective because it provides a robust blood supply and adequate tissue coverage for the fistula.

A buccal advancement flap involves mobilizing tissue from the buccal aspect of the alveolar ridge, which allows for the creation of a flap that can be advanced to cover the defect. This method offers several advantages, including superior vascularity from the buccal mucosa, which enhances healing and decreases the likelihood of fistula recurrence. Additionally, by employing a flap, it allows for more significant manipulation of surrounding tissues to ensure a tension-free closure, which is vital for optimal healing.

Using sutures alone would not be sufficient, as it lacks the additional tissue support necessary to effectively close the fistula and prevent re-entry of food or fluids into the sinus. Similarly, although the term “buccal advancement procedure” might sound similar, it does not explicitly state the method of utilizing a flap for closure. Observation alone is inadequate since it would not resolve the fistula and could lead to exacerbation of