Surgical Management of Buccosinusal Communications Using a Bichat Bag Flap: Case Report and Clinical Analysis
Keywords:
Comunicaciones bucosinusales, Colgajo de Bolsa de Bichat, Cirugía oral y maxilofacial, Regeneración tisular, Tratamiento quirúrgico de CBSAbstract
Buccal sinus communications (CBS) are pathological anomalies that are distinguished by the incorrect connection between the oral cavity and the maxillary sinus, usually arising after the extraction of upper third molars, due to the intimate anatomical relationship between the posterior dental roots and the maxillary sinus. Once this condition is detected, its adequate solution is crucial to avoid complications such as chronic sinus infections, maxillary sinusitis or the appearance of persistent oroantral fistulas.
There are several treatment alternatives, either surgical or non-surgical, for the treatment of SBC. The most commonly used surgical procedures include the use of soft tissue flaps, bone grafts, regenerative biomaterials and the Bichat Bag flap, a biocompatible option that promotes closure of the communication without causing tension in the impacted area.
The purpose of this research is to present a clinical case on the use of the Bichat pocket flap in the surgery of buccosinusal communications, highlighting its effectiveness and benefits in aspects of biocompatibility, vascularization and ideal healing. The study was conducted by reviewing scientific literature, including theses, scientific publications, clinical case reports and relevant literature reviews of the last five years.
The results of this study indicate that the application of the Bichat Bag flap is an effective, safe and expected surgical alternative for the treatment of SBC, reducing postoperative complications and promoting tissue regeneration in the affected area.
Downloads
References
1. Parise Vasco JM, Armas Vega A, Agurto Castro J. Uso de bolsa adiposa de Bichat pediculada como recurso para el cierre de comunicaciones y fístulas bucoantrales: informe de caso. Odontología Vital. 2020 [citado 11/05/2025];2(33):7-14. Disponible en: https://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S1659-07752020000200007
2. Funes Pivetta GN, Cores BA, Soler CN, Beltran Bedogni L, Arienza F. Tratamiento de comunicaciones bucosinusales y buconasales. Reporte de cinco casos de diferente etiología/Treatment of oroantral and oronasal communications. Report of five cases with different etiology. Rev Asoc Odontol Argent. 2023 [citado 11/05/2025];1-8. Disponible en: https://www.researchgate.net/publication/374895588_Tratamiento_de_comunicaciones_bucosinusales_y_buconasales_Reporte_de_cinco_casos_de_diferente_etiologia_Treatment_of_oroantral_and_oronasal_communications_Report_of_five_cases_with_different_etiology
3. Bravo Cordero G, Minzer Ferrer S, Fernández L. Sinusitis odontogénica, fístula oroantral y su reparación quirúrgica mediante colgajo de bolsa de Bichat: revisión de la literatura. Acta Otorrinolaringológica Española. 2016 [citado 11/05/2025];67(2):107-13. Disponible en: https://www.elsevier.es/es-revista-acta-otorrinolaringologica-espanola-102-articulo-sinusitis-odontogenica-fistula-oroantral-su-S0001651915000862?referer=buscador
4. Gallegos AM, Figuerido R, Rodriguez A, Cosme- Gay E. Utilización del colgajo pediculado de la bola adiposa de Bichat en el cierre de comunicaciones bucosinusales. A propósito de 8 casos. Dialnet. 2011 [citado 11/05/2025];16(2):105-110. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=3611702
5. Vallejo-Rodas AA, Salgado-Chavarría F. Oroantral communications: a literature review and update. Rev Fac Odontol Univ Antioq. 2023 [citado 22/07/2024];35(1):1-16. Disponible en: https://revistas.udea.edu.co/index.php/odont/article/view/349110/20811577
6. Aracena D, Jarpa C, Soto-Alvarez C, Sanhueza C, Hernández-Vigueras S. Distancia entre la Raíz Palatina del Primer Molar Superior permanente y el Piso del Seno Maxilar, Obtenida Mediante Tomografía Computarizada Cone Beam. Int. J. Morphol. 2018 [citado 04/12/2025];36(4):1394-1397. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S071795022018000401394&lng=es
.
7. Denes SA, Tieghi R, Elia G. The Buccal Fat Pad for Closure of Oroantral Communication. Journal of Craniofacial Surgery. 2016 [citado 04/12/2025];27(3):e327-30. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27100645/
8. Hilber EM, García Blanco M, Lazarte C, Santucci V, Ariel Puia S. Utilización del colgajo de bolsa adiposa de Bichat para el cierre inmediato de defectos quirúrgicos en el paladar. Reporte de dos casos. Odontol Sanmarquina. 2021 [citado 04/12/2025];24(4):365-71. Disponible en: https://revistasinvestigacion.unmsm.edu.pe/index.php/odont/article/view/19045/17236
9. Ahmed Said WM. Closure of Oroantral Fistula Using Titanium Plate with Transalveolar Wiring. J Maxillofac Oral Surg. 2013 [citado 04/12/2025];14(1):121-5. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC4339339/pdf/12663_2013_Article_584.pdf
10. García Vergara JG. Uso de la bolsa adiposa de Bichat en cirugía oral. [Tesis] Ecuador: Universidad regional autónoma de Los Andes “Uniandes”; 2022. [citado 04/12/2025]. Disponible en: https://dspace.uniandes.edu.ec/bitstream/123456789/14751/1/UA-ODO-EAC-009-2022.pdf
11. Sánchez A, Gonzáles M, Gonzales G. Cierre de comunicación oroantral mediante el uso de membrana de plasma. Revisión de la literatura y reporte de un caso clínico. Rev ADM. 2018 [citado04/12/2025];75(3):153-158. Disponible en:
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Víctor Manuel Barragán Guillén , Julissa Nicole Moreno Díaz , Óscar Ismael Ruiz Ávila
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
ACCESS AND DISTRIBUTION POLICY
All published articles are open access contributions, which are distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License which permits unrestricted non-commercial use, distribution and reproduction in any medium, provided that the primary source of publication is properly cited.
