Introduction
The maxillary bone has a key role in the midface by supporting the adjacent structures including orbit, nose, and palate. Thus, any defect in maxilla may result in functional and aesthetic impairments. Two main causes of maxillary defects include trauma and resection due to pathologic lesions.
Surgical and nonsurgical approaches have been proposed to reconstruct maxillary defects. Nonsurgical approaches, including conventional prosthetic obturators, have disadvantages including poor aesthetics, lack of retention and limited ability to regain normal function (1). Surgical treatment includes local flaps, including pedicled flaps from the buccal fat pad or temporalis muscle flaps, and free grafts with or without microvascular pedicle. Pedicled buccal fat pad flap (PBFPF) is widely used for soft tissue closure in maxillary defects or oro-antral fistulas (OAF) (2). Re-epithelialization of this flap occurs with minimum complications (3). Furthermore, the iliac bone graft is one of the best options of choice for hard tissue reconstruction in the maxillofacial region, providing a sufficient cortico-cancellous bone for large defects (4).
This article presents a 21-year-old male with OAF and oro-nasal Fistula due to right-side palatal pleomorphic adenoma (PA) and subsequent hemimaxillectomy. The defect was reconstructed secondarily with PBFPF and iliac bone graft followed by implant-supported prostheses.