Known and less known operative methods are described and their advantages and disadvantages analysed. Oroantral fistula an overview sciencedirect topics. Surgical anatomy of maxillary sinus note on oroantral fistula. The case was send it to us in order to repair and to build a. C absorbable 40 catgut suture on the right maxillary sinus mucosa. An oroantral fistula is a complication of the maxillary posterior teeth that can occur after a tooth extraction that affects the maxillary sinus. Sixmonth postoperative panoramic radiograph showing the defect filled new bone. It is usually associated with maxillary sinusitis, where drainage of sinus infection is a mandatory step during closure of the fistula. Oroantral fistula article about oroantral fistula by the. Treatment of oroantral fistula a study introduction oroantral communication followed by oroantral fistula oaf is a rare surgical complication in oral and maxillofacial surgery. Oroantral fistula, ask a doctor about diagnosis, treatment.
Rhinosinusitis associated with postdental extraction chronic oroantral fistula. Oroantral fistula definition of oroantral fistula by the. Treatment of oroantral fistula with autologous bone graft and. We recovered the oroantral communication using the sliding flap, without suture in both plans figures 3b and 3c. Oroantral communication oac is the space created between the maxillary sinus and the oral cavity, which, if not treated, will progress to oroantral fistula oaf or chronic sinus disease. May 21, 2016 a fistula latin a pipe or tube is an abnormal communication between the lumen or surface of one organ and the lumen or surface of another or between vessels. Treatment of oroantral fistula with autologous bone graft. Alternative surgical management of oroantral fistula using. The treatment proposed was the oroantral fistula closure with bichats fat pad.
A late buccosinusal fistula in the 1516 tooth area. Oroantral fistula definition of oroantral fistula by. Oaf mostly results from insufficient knowledge and preparation before dental. Anteriorly based palatal flap for closure of large oroantral fistula oral surg oral med oral pathol oral radiol endod 1996. Treatment of oroantral fistula jama otolaryngologyhead. Various surgical methods and approaches have been described in the literature for the treatment of oroantral fistulas and each of them has its specific. Intraoral postoperative appearance of the operation side after six months. This retrospective single center study includes all patients with. Case of oroantral communication closure using a pedicled buccal fat pad graft. It is the purpose, therefore, of this paper to outline those modern. Prosthodontic management of oroantral fistula international. Surgical options in oroantral fistula treatment scienceopen. Oroantral fistula oaf is an epithelialised oroantral communication oac. An oroantral fistula oaf is a pathological abnormal communication between the oral cavity and the maxillary sinus which may arise as a result of failure of primary healing of an oaf, dental infections, osteomyelitis, radiation therapy, trauma, or iatrogenic complications.
Your dentist determines the best treatment options for your dental fistula based on the cause of the infection. In some cases, a very small fistula may be treated without surgery. Introduction oac is a complication of surgery which result in a connection between oral cavity and maxillary sinus. No treatment required as it will usually naturally heal. Modern management of oroantral fistula jama otolaryngology.
Alternative method to treat oroantral communication and. Jun 01, 2012 treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants. An oroantral fistula oaf may develop as a complication of dental extractions, as a result. Oroantral fistula oaf is an abnormal condition that manifests a pathological communication between the maxillary sinus and the oral cavity. Rhinosinusitis associated with postdental extraction chronic. The creation of an oac is most commonly due to the extraction of a maxillary upper tooth typically a maxillary first molar closely related to the antral floor floor of the maxillary sinus. Surgical options in oroantral fistula treatment europe pmc.
A dental fistula is closely linked to gum infections and diseased teeth. Closure of oroantral fistulae can be accomplished by using broadbased lingual or facially rotated flaps figs. Buccal flap, buccal pad of fat, oroantral fistula, palatal flap. May 25, 2015 four month a go a sinus lift was performed and an oroantral communication and fistula was created. Oroantral fistula repair with different surgical methods. The operated case had no complications and the oroantral communication was cured. Jan bellows surgical treatment before surgery, a complete oral examination eg, toothbytooth assessment with periodontal probe, fullmouth intraoral radiography must be performed while the patient is under general anesthesia. Many chronic oroantral fistulas treated in the past could have been prevented had certain steps been taken immediately after their occurrence. Closure of oroantral fistula through a combined use of buccal fat pad and buccal advancement flap is a safe and reliable method, with few complications and provides an adequate barrier to withstand a mild degree of sinus inflammation which is invariably present in the setting of an oroantral fistula. The clinical practice most frequently involves the mono.
Surgical options in oroantral fistula treatment fulltext. Openings smaller than 2 mm may heal spontaneously, whereas larger openings require surgical treatment. Removal of maxillary molars may occasionally results in oro antral communication. B circular incision around the fistula and mucosa displacement on the fistulous path. With the presence of a fistula, the maxillary sinus is permanently open. Dona bhattacharya surgical anatomy of maxillary sinus note on oaf contents. Carefully follow the patient after 12 weeks and advise to avoid straining the area no holding back sneezes, no smoking, no use of straws, no pressure on the sinus. A pathologic communication between the oral cavity and the maxillary sinus, most commonly a complication of maxillary premolar molar tooth extraction. An unnatural communication between the maxillary sinus and oral cavity is known as oroantral communicationoac and if it does not close spontaneously, it is epithelialized so that oroantral fistula develops.
Oroantral fistulas are a pathological communication between the oral cavity and the maxillary sinus antrum. Oroantral communication closure using a pedicled buccal fat. Treatment of oroantral fistula vanja vuksan tomislav lauc. Various surgical options pulkit khandelwal 1, neha hajira 2 abstract 2ur dqwudofrppxqlfdwlrqdqg. Fistula forms because of oral epithelial migration into the fistulous communication. Surgical options in oroantral fistula treatment the open dentistry. An oroantral fistula can occur as the consequence of a postoperative acute sinusitis or of a sinusal mucosa perforation sequent to implants placement6,7,8. Note the opacification of the maxillary sinus, indicating chronic infection. This happens when perforation lasts at least 4872 hours9. Oroantral, fistula, flaps, grafts, maxillary sinus, complication management, oral surgery, decision, oroantral communication. An oroantral fistula oaf creates a passage for oral microbes into maxillary sinus with numerous possible complications. Observe the arrow pointing to the adipose tissue in position. Its treatment involves removal of the oroantral fistula, surgery of the maxillary sinus and closure of the oroantral defect 1,2,5.
We harvested a sliding palatine flap at partial thickness. Oroantral fistula oaf is a relatively uncommon complication of maxillary molar. Treatment of oroantral fistula in pediatric patient using. There is a necessity for improvement in the manner in which these lesions are managed.
Four month a go a sinus lift was performed and an oroantral communication and fistula was created. An oroantral communication oac is an open con nection between the oral. Pdf surgical options in oroantral fistula treatment. Treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants. Management of oroantral communication using buccal.
The current prospective study showed that a onestage, combined endoscopic and intraoral approach under local anaesthesia represents a feasible and minimally invasive procedure for the longterm effective treatment of chronic complicated oroantral communications. Antibiotics, oral care, nasal decongestants, and analgesics are recommended postoperatively. The treatment proposed to the patient was closure of the oroantral fistula using palatine flap. The site of anastomosis should be free of tension and situated over intact alveolar bone. He or she will deep clean the infected areas around the dental. Oroantral fistula oaf is a pathologic communication between the oral cavity and the maxillary sinus. Adele scattarella 1, andrea ballini 1, felice roberto grassi 1, andrea carbonara 1, francesco ciccolella 1, angela dituri 1, gianna maria nardi 2, stefania cantore 1, francesco pettini 1. The oroantral fistula is a pathological connection between the maxillary sinus and with. Treatment of oroantral fistula with autologous bone graft and application of a nonreabsorbable membrane adele scattarella1, andrea ballini1, felice roberto grassi1, andrea carbonara1, francesco ciccolella1, angela dituri1, gianna maria nardi2, stefania cantore1, francesco pettini1 1. Inadvertent communication with the maxillary sinus can occur. Buccal flaps to close the fistula may be more difficult after a sinus graft because of the location of the graft site. Oaf closures can be achieved using different flaps which show both advantages and limitations.
Treatment of oroantral fistula with autologous bone graft and application of a nonreabsorbable membrane. The object of this study is to remind the reader of the iatrogenic pos. The management of bisphosphonate related necrosis of the jaw has become clinical routine. Decisionmaking in closure of oroantral communication and fistula. These complications occur most commonly during extraction of upper molar and premolar teeth 48%. Oroantral communication and fistula can occur as a result of inadequate and improper treatment. The most used techniques for the treatment of oaf involve buccal flap. Oroantral communication closure using a pedicled buccal. Hence, the treatment of choice was closure of the oroantral fistula by giving an obturator. Oac refers to an abnormal connection between the oral cavity and antrum or maxillary sinus. Treatment of oroantral fistula with autologous bone graft and application of a. Summary closure of oroantral fistula may often be a difficult problem presenting a chal lenge to the oral surgeon. It is the intention of this article to discuss the problems in the treatment of oroantral fistulas and to represent an operation for their closure that has not.
Terminology the term oroantral fistula is similar to but not synonymous with the term oroantral communication oac. The flap used for closure of oaf should be tension free, broadly based and well vascularized. The case was send it to us in order to repair and to build a new condition for the implant placement. Treatment of oroantral fistula a study debrided up to the well perfused tissue, and the infected bone should be curetted. Treatment of chronic oroantral fistula with plateletrich fibrin clot and. Therefore they all need careful consideration in order to select the best. Review open access surgical options in oroantral fistula management. A dentist or oral surgeon may apply gauze or another product over a blood clot that forms. Alternative surgical management of oroantral fistula e341 fig. Pdf communication between the maxillary sinus and oral cavity is a common complication in oral surgery. Overview of the treatment modalities of oroantral communications. Treatment of oroantral fistula jama otolaryngology. Treatment of oroantral fistula acta stomat croat 2002. Oral fistula oaf is a pathological communication between the oral cavity and maxillary sinus which has its origin either from iatrogenic complications or from dental infections, osteomyelitis, radiation therapy or trauma.
Surgical options in oroantral fistula treatment article pdf available in the open dentistry journal 61. The closure of an oroantral communication of any origin, can be achieved by different techniques. Pictures and surgical repair of oroantral fistula, following upper molar extraction. Closure of oroantral fistula with buccal fat pad flap and. Oroantral fistulae may develop postoperatively, especially if the patient has a history of past sinus pathology or infection. Oct 01, 2010 buccal advancement flap is a simple and easy to master technique to close oroantral fistula. A coronal ct scan of the sinuses, showed a defect in the floor of the left maxillary antrum, corresponding to the oroantral fistula. Small oroantral fistulae note on oroantral fistula.
Saleh bakry assistant professor of oral and maxillofacial surgery 2. Oroantral communication oral and maxillofacial surgery. While approximately two thirds of the lesions are in the mandible, one third is located in the maxilla. This retrospective study evaluates the success of three different surgical techniques of oaf repair. The treatment need an approach that presents the capacity to promote closure of the communication or fistula, leading to the recovery of health. If the initial treatment of an oroantral perforation fails and fistula formation occurs, the treatment of the oroantral fistula may require the combination of medical and surgical interventions. An oroantral fistula oaf may develop as a complication of dental extractions, as a result of infection, or as sequelae of radiation therapy, trauma, and removal of maxillary cysts or tumors. Oro antral fistula it is an abnormal epithelized communication between maxillary sinus and oral cavity through perforation in the sinus wall 3.
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