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

Abstract

Background: Search of the English literature yielded no studies assessing the chosen dental treatment following surgical closure of oroantral communication/oroantral fistula (OAC/OAF). The purpose of the present study was to assess factors affecting the decision to rehabilitate the posterior maxilla following surgical closure of OAC/OAF. Methods: Consecutive patients at a single center. A structured form served to collect the data. The differences between groups (cases with versus cases without restoration) were assessed statistically. Results: A total of 58/121 responding individuals (62.1% men). Average age 51.57 years. Average waiting time prior to restoration 10.34 months. Most (51.7%) healthy. Most had a dental etiology (60.3%). Thirty-nine (67.2%) patients had a restoration of the posterior maxilla. Most of the patients responded that the reason not to do any restoration is the fear of failure (65.5%). Most of the patients completed the restoration procedure in a private clinic (87.2%). Only one patient (2.6%) reported a complication. Approximately half of the patients had implant supported prosthesis (ISP) following sinus augmentation (48.3%) with delayed implant placement. Most of the patients responded that the reason not to have ISP was the fear of failure (72.7%), and the rest responded because of financial issues (27.3%). For tooth supported restoration, most of the patients responded removable (90.9%).Conclusions: Surgeons generally wait 6-12 months following surgical treatment of OAC/OAF prior to reconstruction with ISP. The chance for complications is low. Healthy women after dental induced OAC/OAF have the highest chances to seek for ISP in such circumstances.

Appropriate Implant Rehabilitation in Patients With Iatrogenic Oroantral Fistula and Odontogenic Maxillary Sinusitis

“…In every OAF case, maintaining a disease-free maxillary sinus membrane without infective microorganism is important for the functional recovery of maxillary sinus. In line with our study, previous study16 suggested 6 to 12 months waiting period after OAF closure for implant rehabilitation 16. A regular follow-up through clinical and radiographic examinations after the MESS with at least 4 to 5 symptoms among 7 sinonasal symptoms including nasal obstruction with facial pain, purulent rhinorrhea, foul odor, foul taste, headaches, anterior maxillary tenderness, and postnasal drip should be resolved 1.…”

“…In line with our study, previous study 16 suggested 6 to 12 months waiting period after OAF closure for implant rehabilitation. 16 A regular follow-up through clinical and radiographic examinations after the MESS with at least 4 to 5 symptoms among 7 sinonasal symptoms including nasal obstruction with facial pain, purulent rhinorrhea, foul odor, foul taste, headaches, anterior maxillary tenderness, and postnasal drip should be resolved. 1 Moreover, water's view plays important role in determining the changes of air-fluid level of maxillary sinus in every periodic follow-up.…”