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.