• Robert J Weinstock, Levon Nikoyan, and Harry Dym.
• Resident, Department of Oral and Maxillofacial Surgery, Woodhull Medical and Mental Health Center, Brooklyn, NY. Electronic address: rjw2119@columbia.edu.
• J. Oral Maxillofac. Surg. 2014 Feb 1; 72 (2): 266.e1-7.

PurposeWe propose a 3-layer composite closure technique for an oral antral communication (OAC) while avoiding secondary donor site morbidity.Patients And MethodsA patient had developed a 1-cm OAC after extraction of right maxillary first molar. The patient subsequently developed acute maxillary sinusitis. The patient was taken to the operating room, and a Caldwell-Luc procedure was performed. The bony window from the Caldwell-Luc was "press fit" over the bony OAC defect. Soft tissue closure was then achieved with a buccal fat pad flap and a buccal mucosal advancement flap. The patient was examined on postoperative day 5 and 1, 2, 3, 6, and 10 months postoperatively.ResultsThe acute sinusitis had resolved. The soft tissue closure was successful. The bone graft remained intact, prevented sinus pneumatization, and restored continuity to the floor of the maxillary sinus.ConclusionsThe presented technique for 3-layer closure of OACs allows for the stability of a double-layer closure of OAC with the added benefit of bone grafting from single operative site, achieving stable oral antral closure, bone grafting, and the avoidance of secondary donor site morbidity.Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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