Treatment for Oroantral Communications of 170 Cases

An oroantral communication (OAC) is an abnormal communication between the oral cavity and the maxillary sinus. Such a communication may cause ingress of microorganism from the oral cavity into the antrum leading to maxillary sinusitis and develop into an oroantral fistula (OAF). Many techniques have been proposed for the closure of OAC, and the best treatment method for OAC is still debated. In the various cases of struggling to close is seen here and there, we have achieved good results of the surgical repair of OAC in our department.

We studied 170 cases (male 97 cases, female 73 cases) of the closure of OAC and OAF during the five-and-a-half year of April 2008 to October 2013, which cases were all performed in our department. In each case, we examined the patient's age, sex, etiology, presence or absence of maxillary sinusitis. Then, we presented the surgical procedure of surgical closures using figures that are performed in our department actually.

As a result, in 169 cases out of the 170 cases, good treatments are shown. In one case, suture dehiscence was observed and a second surgical procedure was necessary. The average age was 47.8 years, minimum age is 14 years, and maximum age was 81 years old. The gender distribution age, the number of cases was the highest in the 60s men and 30s women. The most frequent cause of OAC was the extraction of the first upper molar, followed by second upper molar, third upper molar, second upper premolar, first upper premolar, and upper canine. Sinusitis was observed in 87 patients. These cases were treated after the maxillary sinusitis has been cured.

We have used buccal advancement flap technique in all cases. We show below a typical case of the surgical closure of OAC. In this case, a broad-based trapezoid mucoperiosteal flap was created. After cleaning the communication, the alveolar bone was smoothed, and the flap added relaxation incision was advanced and sutured to the palatal tissue by means of mattress sutures. After the operation, a surgical packing or a surgical splint was prepared and used for 1 week.

 In conclusion, we suggested that our surgical procedure have achieved a good performance.

References

A. Abuabara, A. L. V. Cortez, et al : Evaluation of different treatments for oroantral/oronasal communications: experience of 112 cases. Int J Oral Maxillofac Surg 35: 155-158, 2006.

Nuray Re, Hakan Yusuf Tuncer, et al : Treatment of Oroantral Fistulas Using Bony Press-Fit Technique. J Oral Maxillofac Surg 71:659-666, 2013.