The Modified Caldwell-Luc Approach with the Use of Collagen Material for Treatment of a Chronic Perforated Maxillary Sinusitis

Abstract

Oroantral fistula (OAF) often develops after extraction of posterior maxillary teeth and requires surgical closure. If it persists, OAF may result in maxillary sinusitis. This paper reports a case of an oroantral fistula, associated with chronic maxillary sinusitis. A 46-year-old female patient presented with a history of traumatic tooth extraction, which led to OAF formation. Three unsuccessful attempts were made to close it elsewhere. With one operation, we performed Caldwell-Luc surgery and closed OAF with a collagen membrane and plug and a buccal flap. The patient was assessed at 1-, 3-, 6-, and 12-month and 8-year follow-up visits, with no signs of maxillary sinusitis or OAF recurrence being found with the efficient amount of bone and opportunity for further dental rehabilitation like sinus lifting and dental implantation. We believe that this approach may be a viable option in similar cases.

Modified Endoscopic-Assisted Approach for Removal of Ectopic Third Molar in the Maxillary Sinus

“…Therefore, additional membrane is required to isolate the maxillary sinus from the oral cavity, and many techniques have been proposed to close the antrostomy site, such as using a collagen plug, membrane, and/or autogenous platelet-rich fibrin membrane [14]. However, repositioning the bony window may be a better option due to the following advantages: the osteoinductive and non-immunogenic properties of the autogenous bone, no additional membranes are needed, and it better prevents soft tissue migration into the sinus cavity [14,15]. Also, securing the bony window with a microplate facilitates optimal stability and bone healing.…”