case_images: PMC4555957_01
case_images: Radiographic aspect immediately after firearm accident
case_images: AMS-5-89-g001.jpg
case_images: PMC4555957_01_AMS-5-89-g001.jpg
case_images: F1
case_images: 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].
case_images: Oroantral fistula
case_images: AMS-5-89-g002.jpg
case_images: PMC4555957_01_AMS-5-89-g002.jpg
case_images: F2
case_images: After that, definitive surgical procedure was performed to treat persistent OAF [Figures 2 and 3].
case_images: Cone beam computed tomography - Note bone defect in left maxilla
case_images: AMS-5-89-g003.jpg
case_images: PMC4555957_01_AMS-5-89-g003.jpg
case_images: F3
case_images: After that, definitive surgical procedure was performed to treat persistent OAF [Figures 2 and 3].
case_images: Bone defect - Compare with clinical aspect
case_images: AMS-5-89-g004.jpg
case_images: PMC4555957_01_AMS-5-89-g004.jpg
case_images: F4
case_images: 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].
case_images: Titanium mesh
case_images: AMS-5-89-g005.jpg
case_images: PMC4555957_01_AMS-5-89-g005.jpg
case_images: F5
case_images: 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.
case_images: Healing status of oroantral fistula on 40th postclosure day
case_images: AMS-5-89-g006.jpg
case_images: PMC4555957_01_AMS-5-89-g006.jpg
case_images: F6
case_images: The patient remained under follow-up of 06 months, when complete closure of OAF and tissue repair was noted [Figures 6 and 7].
case_images: Complete closure of oroantral fistula and epithelization - after 18 months
case_images: AMS-5-89-g007.jpg
case_images: PMC4555957_01_AMS-5-89-g007.jpg
case_images: F7
case_images: The patient remained under follow-up of 06 months, when complete closure of OAF and tissue repair was noted [Figures 6 and 7].