A technique for presinus lift repair and secondary closure. The aim of this study was to assess the effectiveness of closure. Various techniques have been examined for the closure of oroantral communications. Primary closure of a sinus perforation primary closure of a sinus perforation is indicated for large. Closure of oroantral communication using guided tissue. Success was accessed by complete closure of communication or fistula. Saleh bakry assistant professor of oral and maxillofacial surgery 2. These findings thus correlate with those made by obwegeser a and tschamer 1957 and by killey. Chronic oroantral fistula may complicate into chronic sinusitis and its sequelae. Various surgical options pulkit khandelwal 1, neha hajira 2 abstract 2ur dqwudofrppxqlfdwlrqdqg.
Early treatment of oac is very important to prevent formation of an oroantral fistula oaf, to avoid development of chronic maxillary sinusitis, and. The upper lateral teeth when removed has a tendency to form blood clots. The decisionmaking in closure of oroantral communication and fistula is influenced by many factors. Oroantral fistula oaf can be defined as a pathologic communication between oral cavity and maxillary sinus and is usually located between the antrum and vestibule. Oroantral fistula an overview sciencedirect topics. Oroantral communication and fistula can occur as a result of inadequate and improper treatment.
Treatment of oacs identified in their early stages is based on a surgical procedure that provides adequate communication closure and the correct patient. Management of oroantral fistula and related surgical. A technique for the closure of oroantral communications using guided tissue regeneration is described. Oro antral fistula it is an abnormal epithelized communication between maxillary sinus and oral cavity through perforation in the sinus wall 3. We present a technique in which nasoseptal cartilage graft is used for the closure of the oroantral. The objective of the study was to determine the most vulnerable sites and side involved in oroantral fistula creation. Pdf after removal of a dental implant or extraction of a tooth in the upper jaw, the closure of an oroantral fistula oaf or oroantral communication. Pdf closure of oroantral fistula by using buccal fat pad. A rotational flap of the buccal mucosa was then elevated with the bovieelectrocautery device. Oroantral fistula oaf is a pathologic communication between the oral cavity and the maxillary sinus.
Decisionmaking in closure of oroantral communication and. The antibiotic was continued for 6 weeks because of bone infection, resulting in successful closure of the surgical defect, without oroantral fistula, and resolution of pain see figure 81, d. L treatment of oroantral fistula by gold foil closure. They can arise as late sequelae from perforation and last at least 4872 h. Closure of oroantral fistula with pedicled buccal fat pad.
Use of double layer technique for closure of oroantral fistula our experience. Closure of oroantral fistula 59 or the caldwellluc procedure. Oac refers to an abnormal connection between the oral cavity and antrum or maxillary sinus. However, these materials are not widely accepted in routine surgical closure of oaf due to cost, difficult handling, increased rate of infection, and exfoliation.
For the closure of oroantral fistula, many techniques have been described. The present article shows a clinical case of the closing of oroantral. Maxillary sinus, oroantral communication, oroantral. An oroantral communication oac is an open con nection between the oral. The most common causes of complications include inadequate site preparation, flap closure, flap necrosis, infection, and patient non. Site sutured after closure palatal tissue healing 24. 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.
Oroantral fistula closure an oroantral fistula will not heal spontaneously and must be surgically repaired. Furthermore, improper treatment of oac can produce maxillary sinusitis and become chronic 8. Closure of oroantral fistula using titanium plate with. 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 received the recognition it deserves. The term oroantral fistula is used to indicate a canal lined by epithelium that may be filled with granulation tissue or polyposis of the sinus membrane. Local and distant flaps as well as combination of flaps can be used for closure of oaf. Oaf could be caused by dental infection, osteomyelitis, radiation therapy, trauma or following removal of maxillary cysts or tumors. The bony fragment itself was then debrided back to healthy bleeding tissue. In the past few decades, an extensive pool of literature has developed pertaining to surgical closure of the oaf. To overcome the above drawbacks this study aimed to use titanium plates 0. Fibrosis sets in within the clot material aiding the healing process. This is a fistulous communication between the floor of the maxillary sinus to the oral cavity. Oroantral fistula oaf is a relatively uncommon complication of maxillary molar extraction.
The healing of the wound and closure of the defect could be seen after a 30day postoperative period, with complete epithelialization. New technique for closure of an oroantral fistula using plateletrich fibrin the fistula is excised under local anaesthesia and the sinus is lavaged with a solution of normal saline and gentamicin. The surgical technique presented for this case could be an interesting approach because the fixed or removable prosthetic treatment will be more effective if the. 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. The patients with acute oac underwent operation immediately. Oroantral communication closure using a pedicled buccal. Comparative study, authorahmad al nashar and hasan m. Repair oroantral fistula otolaryngology coding ask an. Decisionmaking in closure of oroantral communication and fistula. References andrea enrico borgonovo, frederick valerio berardinelli, marco favale, carlo maiorana. Oroantral communication oac acts as a pathological pathway for bacteria and can cause infection of the antrum, which further. Marta del rey santamaria, eduard valmaseda castellon. The flap used for closure of oaf should be tension free, broadly based and well vascularized.
Oroantral fistula is an uncommon complication in oral surgery. This commonly occurs following dental extraction of infected upper molar and premolar tooth. Oroantral fistula oaf is an epithelialised oroantral communication oac. Previous narrative research has focused on assessments and comparisons of various surgical techniques for the closure of oacoaf.
Oroantral fistula mouth human head and neck free 30. An oroantral fistula oaf can be defined as an epithelialized pathological unnatural communication between the oral cavity and the maxillary sinus. Use of palatal rotation flap in the closure of oroantral. There are advantages and disadvantages of all these techniques. 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. After removal of a dental implant or extraction of a tooth in the upper jaw, the closure of an oroantral fistula oaf or oroantral communication oac can be a difficult problem confronting the dentist and surgeon working in the oral and maxillofacial region.
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. Management of oroantral fistula linkedin slideshare. It is usually associated with maxillary sinusitis, where drainage of sinus infection is a mandatory step during closure of the fistula. The suggested algorithm for the treatment of oaf is illustrated in fig. Consequently, it requires a combination of knowledge, experience, and information gathering. Palatal flap ant titanium mesh for oroantral fistula closure. Oroantral communication and fistula linkedin slideshare.
Alternative surgical management of oroantral fistula using auricular cartilage. Shivani sachdeva abstract various options are available for the surgical management of oroantral fistulae however postoperative wound. Acute and chronic oroantral fistula and sinusitis can occur as a result of inadequate treatment. Chronic oac were treated after irrigation with saline.
Haas r, watzak g, baron m 2003 a preliminary study of monocortical bone grafts for oroantral fistula closure. Alloplastic materials such as tantalum, gold plates and foils, hydroxyapatite blocks have been used for closure of oroantral fistula oaf. Grafting of the pedicled buccal fat pad is thought to be an efficient, safe and easy alternative to a larger oroantral fistula closure. Oroantral fistula definition of oroantral fistula by. Autogenous closure of oroantral comunication juniper publishers. Terry pannkuk, dds, mscd shows the microsurgical repair of an oroantral fistula that developed after an extraction. Treatment modalities for oroantral fistula oaf closure. To show a case report of oroantral fistula and its closure. The oroantral communication is a term includes the oroantral fistula in addition to.
Buccal fat pad for closure of oroantral and oronasal. Closure of oroantral fistula international journal of oral and. The usual pathogens associated with various head and neck infections and their. Suggested by sme walk the moon one foot official video. Pdf closure of oroantral fistula with pedicled buccal. A 6monthsurgical treatment of oroantral fistula, after a tooth removal, using the buccal fat pad method as a pedicled graft associated with a sliding mucosal flap. Pdf decisionmaking in closure of oroantral communication and. Closure of oroantral fistula with buccal fat pad flap and. Various options available for the surgical management of oroantral fistula are as given below flaps. Oroantral communication oac and subsequent formation of oroantral fistula is a common complication of dental extraction of maxillary molars. Closure of oroantral communication using buccal fat pad.
The buccal and palatal mucoperiosteal flap is raised but not mobilised for advancement. Use of double layer technique for closure of oroantral. The aims of this study are to describe and compare the three most common techniques employed in surgical closure of oroantral fistulas. 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. Through the fistula itself, a marked amount of thickened mucosa was stripped out and removed. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. Closure of oroantral fistula by using buccal fat pad or buccal advancement flap.
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