the goal of carefully approaching and identifying the full extent of the defect. A small palatal flap was also raised along the alveolar crest (Figs. 7a and 7b). Once the defect was identified, a series of curettes was used to debride the maxillary sinus of any infected, diseased sinus mucosa and any visible polyps (Fig. 8). The specimens obtained during the sinus debridement were submitted in formalin to the pathologist for histopathologic evaluation. The sinus was then irrigated with sterile saline and 0.12 percent chlorhexidine rinse. The buccal flap was retracted, and the position of the parotid duct was visualized and noted. A 2-centimeter back-cut through the periosteum was performed (Fig. 9) and hemostats were used to perform blunt dissection identifying the buccal fat pad. As the tissues were spread, the buccal fat pad flowed downward. Careful blunt dissection continued to further mobilize the buccal fat pad to extend down over the defect (Fig. 10). Fig. 7a: Initial buccal flap elevation. Note bridge of sinus mucosa/scar band along lateral aspect. Fig. 7b: Demonstration of the extensive size of the defect extending up the lateral maxillary wall. Fig. 8: Debridement of sinus mucosa and polyps. Fig. 9: Mucosal incision through the periosteum to approach the buccal fat pad. Fig. 10: Demonstration of the ease of mobilization and reach of the buccal fat pad. FREE FACTS, circle 29 on card dentaltown.com \\ AUGUST 2017 65http://www.dentaltown.com