Thomas P. Mooneyham, DDS (Oral and Maxillofacial Surgery); Thomas P. Meehan1, DVM; John L. Scheels1,2, DDS
Closing an oroantral tract in an animal other than a human requires general anesthesia for safety of the animal and the clinicians performing the care. It also requires the surgery to harvest the bone and place it in the site. Using AAA (autolyzed, antigen-extracted, allogeneic human bone) grafting material as a xenograft in this animal can afford us the possibility of not having to perform needless donor site surgery, thereby reducing the anesthesia time and the risk of increased morbidity to the animal.
Oroantral fistulae negate the normal pressure variation between the mouth proper and the antrum of Highmore (maxillary sinus). Performing a surgical procedure to close the soft tissues properly and graft the xenograft bone to the existing alveolar bone requires attention to detail. Since 19651 we, in the surgical community, have been aware of the existence of osteoinduction caused by certain proteins in bone graft materials. Drs. Kent, Block,2 Triplett3, et al. have reported in various journal articles about the need to properly place the bone matrix for grafting, and have an appropriate GTR type of material (Boyne4) to protect the bone graft from extensive inflammatory enantiomers.
A discussion of the technique and the reasoning for this technique is offered.
1. Urist MR. Bone: formation by autoinduction. Science. 1965:150:893–899.
2. Block MS, Kent JN. Endosseous Implants for Maxillofacial Reconstruction. Philadelphia, PA; WB Saunders: 1995.
3. Triplett RG, Schow SR, Fields RT. Bone Augmentation with and Without Biodegradable and Nonbiodegradable Microporous Membranes. Oral and Maxillofacial Clinics of North America; WB Saunders: 2001:411–422.
4. Boyne PJ. Regeneration of alveolar bone beneath cellulose acetate filter implants. J Dent Res. 1964;26:569.