Clinical and Radiographic Assessment of cyanoacrylates Opposing Buccal sliding flap for the immediate repair of Oroantral communication

Abstract

Oro-antral communication (OAC) is the inevitable connection between the oral cavity and the maxillary sinus. The most reputable cause of the condition is the extraction of maxillary molars due to the close proximity of their roots to the antral floor which is very thin in this area [1,2] . Moreover, periapical infection, large cysts, tumors and trauma can all be potential causes of oroantral communication [3,4] . It is of utmost importance to close this patent connection as soon as it is recognized to preclude the development of sinusitis with subsequent fistula formation [5] . Several articles recommended the closure of this communication within 24 hours of the incident [6] .Affirmation on the presence of OAC is established through several procedures comprised of clinical examination including Valsalva test, Cheek blowing test and probing of the perforation site through the socket however, this specific technique is not favored anymore as it is associated with several complications as increasing size of the defect and the possible pushing of foreign bodies or bacteria into the maxillary sinus [7,8] . Clinical diagnosis must be followed by radiological confirmation to exclude the presence of any dental roots or foreign bodies near or within the vicinity of the antrum. Radiographs provide accurate assessment of the site and size of the defect. Radiographic maneuvers commonly used are periapical, panoramic view [9] . Computerized Tomography (CT) as well as Cone beam computerized Tomography (CBCT). Nowadays, CBCT is widely used due its high quality, available 3D images, low radiation dose and the accurate details with less artifacts than helical ABSTRACT Introduction: Oroantral communication is an uncommon, inadvertent incident resulting from various causes the most common of which is the extraction of upper molars. Immediate closure of the communication is highly recommended to avoid infection and subsequent fistulous tract formation. Cyanoacrylate tissue glue was introduced as a reliable method for flapless sealing of the communication without any of the complications associated with the surgical maneuvers. One of the oldest surgical procedures used for closure of the Oroantral communication is the buccal advancement flap which proved efficiency in complete closure of the defect with minimal related complications. Aim of the study: The study aims evaluate the immediate flapless closure of Oroantral communication using cyanoacrylates versus the buccal sliding advancement flap. Patients and Methods: Twenty patients suffering from instant oroantral communication were included in the study. CBCT was performed to each of them to confirm the diagnosis, patients were divided into two groups where Group I (Study group) patients were treated by sealing of the defect using periacry l90 HV while Group II (control group) patients performed Buccal sliding advancement flap. Clinical follow up including pain, facial swelling, recurrence of the defect and sulcular depth up were performed at day 1, 3, 7, 15 and 1 month. CBCTs were...