Oroantral communications. A retrospective analysis

Abstract

Objetive. To analyze characteristics, clinical evolution and surgical techniques of oroantral communication (OAC). Study Design. We included all patients operated at the University Central Hospital (Oviedo, Spain) between 1996 and 2007. The variables assessed were age, sex, medical history, OAC size, sinus disease, surgical technique, duration of hospitalization and post-surgical evolution. Results. We analyzed 12 patients (7 men and 5 women) with an average age of 47.5 years. The most frequent cause of oroantral communication was the extraction of the first upper molar. The average size of fistula was 0.9 cm. Buccal flap repair was used in 7 patients, palatal rotation-advancement flap in 4 patients and buccal fat pad in only one patient. Suture dehiscence was observed in one patient treated with a palatal flap, but no additional surgery was required. Three OAC recurred; all of them following a buccal flap procedure. All recurrences spontaneously closed between one and four months following the procedure. Conclusion. OACs are rare complications and treatment should be individualized to avoid further complications.

Use of Bichat s buccal fat pad for the sealing of orosinusal communications. A presentation of 8 cases

“…However, it is best to postpone irradiation until full epithelization of the flap has been completed (8). In order to minimize the incidence of postoperative complications such as necrosis or infection, the flap must adequately cover the entire defect and should be sutured without tension (2). The present study examines the efficacy of the pediculate flap with the buccal fat pad in the sealing of orosinusal communications, describes the surgical technique used, and reports the main per-and postoperative complications observed.…”

“…Orosinusal communications are relatively common in dentoalveolar surgery of the upper molars and premolars, though they also may be caused by cystic disease, infections, tumors or trauma (2). The treatment strategy depends on a range of factors, including the location of the defect, its cause and size (3).…”

“…Anatomically, the buccal fat pad is an encapsulated, rounded and biconvex, mainly adipose structure with an excellent blood supply from the maxillary, superficial temporal and facial arteries (5,7). This triple irrigation system is what makes it possible to use this tissue without much risk of necrosis (2). The fat pad is delimited by the buccinator muscle, the masseter muscle and the ascending mandibular ramus and zygomatic arch (5,7) (Fig.…”

Management of idiopathic alveolar bone necrosis associated with oroantral fistula after upper left first molar extraction

“…1 This patient complained of swelling and pain at post extraction site for 2 months before escaping fluid when drinking, showing that oroantral fistula develop after the presence of osteonecrosis. The maxillary sinus reaches its greatest dimension during third decade of life, so the incidence of oroantral communications should be higher after that age, 4,12 Study conducted by Hernando et al 12 showed that the average age incidence of oroantral communications is 47.5. Oroantral communication commonly caused by: close anatomic relationship between root apices of the premolar and molar tooth and maxillary sinus base (80%), maxillary cyst (10-15%), benign or malignant tumor (5-10%), trauma (2-5%), and other causes.…”

“…Oroantral communication commonly caused by: close anatomic relationship between root apices of the premolar and molar tooth and maxillary sinus base (80%), maxillary cyst (10-15%), benign or malignant tumor (5-10%), trauma (2-5%), and other causes. 4,6,12 If the oroantral communication is maintained open to the oral cavity for more than 48 hours or if there is infection, chronic inflammation of the sinus membrane and permanent epithelization of the fistula will increase the risk of sinusitis. 5 Management of oroantral fistula closure consists of nonsurgical and surgical management.…”