An oroantral fistula oaf may develop as a complication of dental extractions, as a result of. The core of tissue and the fistulous tract are excised. A crosssection of oroantral fistula in the molar region. Decisionmaking in closure of oroantral communication and fistula. Case of oroantral communication closure using a pedicled buccal fat pad graft. They are therefore first seen by the dentist, although the rhinologist may be consulted to help care for the sinus complication. Debride the socket and pack with gelfoam to help form a blood clot. Oroantral fistula mouth human head and neck free 30. Oroantral communication oac acts as a pathological pathway for bacteria. Pdf flapfree treatment of an oroantral communication with. Four month a go a sinus lift was performed and an oroantral communication and fistula was created. Oroantral communication oac and subsequent formation of oroantral fistula is a common complication of dental extraction of maxillary molars.
The oroantral fistula oaf develops if the oac remains open and becomes. After excising the fistula, the mucosa of the two minor flaps of the htype windowlike incision figures 7b and 10 was elevated and separated from the underlying connective tissue without jeopardizing the continuity of the mucosal flap figure 9. C absorbable 40 catgut suture on the right maxillary sinus mucosa. Oroantral communication and fistula can occur as a result of inadequate and improper treatment. Pdf on nov 1, 2015, ugur gulsen and others published flapfree treatment of an oroantral communication with plateletrich fibrin find, read and cite all the. Chronic oroantral fistula may complicate into chronic sinusitis and its sequelae. This retrospective study evaluates the success of three different surgical techniques of oaf repair. It is the purpose, therefore, of this paper to outline those modern. C the epithelium lining the fistula has been excised, the periosteum has been released at the vestibular height of the dissection, and the tension free flap has been closed across the defect, with the margins of the flap resting over bone. Threelayered closure of persistent oroantral fistula using.
Case series abstract oroantral fistula oroantral communications oacs is a pathological communication between the oral cavity and the maxillary sinus which has its origin either from dental infections, trauma, radiation therapy, or osteomyelitis. Oroantral fistula synonyms, oroantral fistula antonyms. Fistula forms because of oral epithelial migration into the fistulous communication. Management of oroantral fistula linkedin slideshare. Oroantral fistula mouth human head and neck free 30day. Oroantral communication and fistula linkedin slideshare. Local and distant flaps as well as combination of flaps can be used for closure of oaf. Jan 01, 2017 oroantral communication oac or fistula oaf is an open pathological communication between the oral cavity and maxillary sinus which mostly occurs as a result of extraction of upper molars and. Pdf palatal rotation flap in management of oroantral. Start studying management of oroantral fistula and related surgical procedures. Management of oroantral fistula and related surgical. Oroantral fistula definition of oroantral fistula by. Consider a nasal steroid spray, such as flonase to limit inflammation of the sinus lining.
A late buccosinusal fistula in the 1516 tooth area. Adequate management should be performed include closing the oaf and elimination of sinus infection to provide good healing and prevent recurrences. In general, most small oroantral oromaxillary fistulas will close spontaneously without any additional intervention. Caldwellluc approach in the treatment of chronic non. Oroantral fistula free download as powerpoint presentation. An incision that extends 15 mm anterior and posterior to the fistula is of benefit. There is a necessity for improvement in the manner in which these lesions are managed. Oroantral communication closure using a pedicled buccal.
In addition to 262 articles on the closure of oroantral, 4 articles on the closure of antrooral fistula in humans, and 5 articles in animals, citations were referenced to identify further relevant. The oroantral fistula oaf is a pathological communication between the maxillary sinus and oral cavity lined by epithelium. Oroantral fistula oaf is an epithelialised oroantral communication oac. Mar 19, 20 use overthecounter sympathomimetics, such as otrivin or sudafed to control sinus congestion for a maximum of 3 days. Pdf a total of 175 patients with oroantral communications have been investigated in a followup study.
Antibiotics, oral care, nasal decongestants, and analgesics are recommended postoperatively. Oroantral communication closure using a pedicled buccal fat. The decisionmaking in closure of oroantral communication and fistula is influenced by many factors. A dentist or oral surgeon may apply gauze or another product over a blood clot that forms. Learn vocabulary, terms, and more with flashcards, games, and other study tools. In patients with a persistent communication between the mouth and the sinus that is symptomatic foul tasting discharge, reflux of air or food into the sinus, or development of a sinus infection, surgical repair is indicated to close the fistula. May 21, 2016 oroantral fistula oaf is a relatively uncommon complication of maxillary molar extraction. May 25, 2015 four month a go a sinus lift was performed and an oroantral communication and fistula was created. The clinical practice most frequently involves the monolayer technique of closing an oroantral defect developed. When oroantral communication is left open, epithelial tissue may develop in its track oroantral fistula. This condition mostly follows dental extraction of molar and premolar maxilla teeth. A key to closing the oroantral opening is the dissection of the buccal flap lateral to the fistula.
In some cases, a very small fistula may be treated without surgery. Its treatment involves removal of the oroantral fistula, surgery of the maxillary sinus and closure of the oroantral defect 1,2,5. Oroantral fistula an overview sciencedirect topics. Buccal flap, buccal pad of fat, oroantral fistula, palatal flap. Treatment modalities to repair the oroantral defects include local or free soft tissue flaps, with or without autografts or alloplastic materials. Oro antral fistula it is an abnormal epithelized communication between maxillary sinus and oral cavity through perforation in the sinus wall 3. Pdf management of oroantral communication and fistula. Consequently, it requires a combination of knowledge, experience, and information gathering. Oroantral fistula repair with different surgical methods.
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. Other causes of perforation into sinus include destruction of a portion of the sinus following facial bone fractures, periapical lesions, removal of large cystic cavity that encroach on sinus cavity and in cleft patients. Modern management of oroantral fistula jama otolaryngology. Openings smaller than 2 mm may heal spontaneously, whereas larger openings require surgical treatment. B circular incision around the fistula and mucosa displacement on the fistulous path. We suggested closure of the fistula using a connective tissue free graft removed.
An oroantral fistula oaf creates a passage for oral microbes into maxillary sinus with numerous possible complications. This happens when perforation lasts at least 4872 hours9. Oroantral medical definition merriamwebster medical. The treatment for an oroantral fistula depends on the patients presentation. Alternative method to treat oroantral communication and. Abnormal connection between the oral and antral cavities. Causes extraction of maxillary posterior teeth most common. The fistula then has an elliptical incision on each side of the opening.
Acute oroantral fistula extraction of one of the upper molar teeth is the usual cause of acute oroantral fistulas. In general, most patients will have spontaneous closure of a small oroantral fistula oroantral fistula creation. Oroantral fistula article about oroantral fistula by the. Oroantral communication oac or fistula oaf is an open pathological communication between the oral cavity and maxillary sinus which mostly occurs as a. Various techniques have been used for the repair of oroantral fistula oaf but majority of them have focused on the soft tissue closure alone, and most of the time, the osseous floor of the sinus was ignored. Many chronic oroantral fistulas treated in the past could have been prevented had certain steps been taken immediately after their occurrence.
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. The case was send it to us in order to repair and to build a new condition for the implant placement. Furthermore, improper treatment of oac can produce maxillary sinusitis. Oroantral fistula definition of oroantral fistula by the. Repair of oroantral fistula via modified endoscopic medial. Oac refers to an abnormal connection between the oral cavity and antrum or maxillary sinus.
Endonasal repair of oafs via memm with free nasal mucosal grafts is feasible and prom. A coronal ct scan of the sinuses, showed a defect in the floor of the left maxillary antrum, corresponding to the oroantral fistula. The treatment proposed was closure of oroantral fistula with vestibular flap. Surgical anatomy of maxillary sinus note on oroantral fistula.
The oroantral fistula oaf is the condition which makes shivers run up and down a dentists spine the condition almost commonly occurs following a complicated upper tooth extraction, when a fistulous communication develops between the oral cavity and maxillary antrum sinus. The case was send it to us in order to repair and to build a. Various surgical options pulkit khandelwal 1, neha hajira 2 abstract 2ur dqwudofrppxqlfdwlrqdqg. Oaf could be caused by dental infection, osteomyelitis, radiation therapy, trauma or following removal of maxillary cysts or tumors. Treatment of oroantral fistula jama otolaryngologyhead. Previous narrative research has focused on assessments and comparisons of various surgical techniques for the closure of oacoaf. An oroantral fistula oaf is the chronic pathologic result. The site of anastomosis should be free of tension and situated over intact alveolar bone. Note the opacification of the maxillary sinus, indicating chronic infection.
Oroantral fistula closure by combined buccal and palatal flaps. In all cases, tooth extraction was the only etiologic factor. Treatment of oroantral fistula a study debrided up to the well perfused tissue, and the infected bone should be curetted. Saleh bakry assistant professor of oral and maxillofacial surgery 2. Jun 01, 2012 the term oroantral fistula is meant to indicate a canal lined by epithelium that may be filled by granulation tissue or by polyposis of the sinus membrane, most frequently due to iatrogenic oroantral communication. Oroantral communication followed by oroantral fistula oaf is a rare surgical complication in oral and maxillofacial surgery. Surgical options in oroantral fistula treatment ncbi. Various options available for the surgical management of oroantral fistula are as given below flaps. Existing literature supports that bone grafts supported by buccal fat pad bfp heal well without undergoing significant resorption and necrosis.
1123 296 1535 472 54 1429 1557 748 543 845 1337 69 14 1300 1400 1187 928 1498 1368 418 612 1336 1380 1454 1453 517 161 1139 734 462 427 962