PMC4555957_01
Radiographic aspect immediately after firearm accident
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F1
A 41-year-old male patient attended the service of Oral and Maxillofacial Surgery, Hospital Regional Agreste Caruaru/PE, victim of firearm projectile wound, with perforation entrance on the palate and accommodation bullet fragmented in the midface [Figure 1].
Oroantral fistula
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F2
After that, definitive surgical procedure was performed to treat persistent OAF [Figures 2 and 3].
Cone beam computed tomography - Note bone defect in left maxilla
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F3
After that, definitive surgical procedure was performed to treat persistent OAF [Figures 2 and 3].
Bone defect - Compare with clinical aspect
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F4
An intrasulcular and paramedian subperiosteal incisions were made on palate, thus forming a full-thickness palatal flap and possible full view of the bone defect of approximately 2 cm in diameter [Figure 4].
Titanium mesh
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F5
A titanium mesh measuring 3 cm x 3 cm, 0.1 mm thick with four screws 1.5 mm x 5 mm was installed in the place [Figure 5], covered with palatine flap and sutured with 4-0 polyglactin 910.
Healing status of oroantral fistula on 40th postclosure day
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F6
The patient remained under follow-up of 06 months, when complete closure of OAF and tissue repair was noted [Figures 6 and 7].
Complete closure of oroantral fistula and epithelization - after 18 months
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F7
The patient remained under follow-up of 06 months, when complete closure of OAF and tissue repair was noted [Figures 6 and 7].