Clinical and radiological characteristics of oro‐antral communications/fistulae due to implant dentistry procedures: A cross‐sectional retrospective study

Abstract

Objectives Assess the unique clinical and radiological sequelae following oro‐antral communications/fistulae (OAC/OAF) due to implant dentistry vs other etiologies. Materials and Methods A structured form served to collect data from medical records. All consecutive patients who underwent surgical closure of OACs/OAFs between 2003 and 2020, at a single center were included. Demographic, radiological, clinical, operative and postoperative characteristics were collected. The differences between groups (cases with implant dentistry etiology [IDE] vs cases with other etiologies) were assessed statistically. Results Data were gathered from 121 cases. The findings show that IDE cases were more likely to be of older age (OR = 1.07, CI [1.02, 1.13] P = .02); to have a foreign body in the maxillary sinus (OR = 21.04, CI [4.34, 114.92] P < .01); to have fluid passage (OR = 11.40, CI [1.87, 118.73] P = .02) and purulent discharge through the fistula (OR = 3.52, CI [0.86, 16.34] P = .09). Conclusions Clinical and radiological sequelae due to OACs/OAFs secondary to implant dentistry procedures are more severe compared to other etiologies. The suggested pathogenesis is foreign body reaction. Early and accurate diagnosis of the foreign body location, followed by its early removal is recommended.

Factors affecting the decision to rehabilitate the posterior maxilla following surgical closure of oroantral communications/fistulae – A cohort study

“…However, implant dentistry might not be considered after surgical closure of OAC/OAF. [8][9][10] A mean waiting time of 10 months was recorded in the restored cases. It can be suggested that such a waiting period was advocated to avoid significant challenges associated with reentry sinus augmentation.…”

“…Because of the ongoing increase in size of the elderly population, widespread availability of implantologists and the improvement in surgical techniques, more and more implants will be placed in more complicated surgical situations in older populations. However, implant dentistry might not be considered after surgical closure of OAC/OAF 8–10 …”

“…Inclusion and exclusion criteria were previously described. 9 These criteria in brief: inclusion: surgical closure of OACs/OAFs, available records and willingness to participate in the survey. Exclusion: posterior maxilla pathology other than a periapical lesion or a radicular cyst, radiation therapy to the maxillofacial region, insufficient data.…”

“…All consecutive patients who underwent surgical closure of OACs/OAFs between 2003 and 2020 at the department of oral and maxillofacial surgery, Rabin Medical Center, Petah Tikva, Israel were contacted using a structured form. Inclusion and exclusion criteria were previously described 9 . These criteria in brief: inclusion: surgical closure of OACs/OAFs, available records and willingness to participate in the survey.…”

“…Sequelae because of OACs/OAFs secondary to implant dentistry procedures are more severe, because of a foreign body reaction. Presence of a foreign body in the sinus was found in significantly high rates (93.18%) following implant dentistry (60% because of bone grafting materials and 33.18% because of dental implants per se) 9 . Reentry sinus augmentation is associated with many surgical challenges, including: existing sinus disease not related to a dental cause, osteomeatal obstruction, limited bone volume, adhesions of the buccal flap, bony fenestration of the lateral wall, limited mobility of a fibrotic Schneiderian membrane and increased incidence of membrane perforations.…”