Oroantral fistulas (OFs) are a difficult complication encountered in oral and maxillofacial surgery, typically requiring operative management to restore sinus integrity. The Bichat buccal fat pad (BFP) has emerged as a workable solution for sealing OF. The present investigation examined the effectiveness, safety profile, and therapeutic outcomes of BFP mobilization for OF repair. Twenty individuals presenting with OF were enrolled in this prospective study. The operative protocol consisted of dissecting free and sliding the BFP forward to bridge the defect. Follow-up evaluations were conducted at 7 days, 45 days, and 6 months after the operation, including both physical examination and image-based review. The main outcome measure was confirmed fistula sealing at the 6-month mark, and additional tracked endpoints covered adverse event frequency, sinus clouding on computed tomography, pain severity, and gains in everyday well-being. A total success proportion of 85.7% was recorded, with full fistula sealing observed across 18 of the 21 treated sites (including a single patient treated on both sides). Low-grade adverse events were documented in 14.3% of the cohort. Computed tomography at the half-year point revealed complete clearing of sinus clouding in 81% of individuals treated. Marked reductions in pain ratings and meaningful gains in well-being were self-reported. Advancing the BFP stands as a potent, well-tolerated, and tissue-sparing approach for closing OF, delivering elevated success proportions alongside encouraging clinical and imaging endpoints. The data substantiate the adoption of the BFP as a trustworthy alternative in the surgical armamentarium for the treatment of OF in oral and maxillofacial practice.
