Management of the Oroantral Fistula

Abstract

Communication between the maxillary sinus and oral cavity is a common complication in oral surgery. It results mainly from maxillary premolar and molar extractions when the sinus floor is close to the tooth apex. It can also occur after an infection involving the maxillary teeth, invasion of the sinus cavity by a cyst or carcinoma, trauma, the Caldwell-Luc operation, or other dentoalveolar or implant procedures. Openings smaller than 2 mm may heal spontaneously, whereas larger openings require surgical treatment. 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. Various techniques have been examined for the closure of oroantral communications. However, the most common question is how to provide better healing of the defect area and the donor site. In this chapter, etiology, clinical features, medical and surgical managements of OAFs, and advantages and disadvantages of different closure methods of closure techniques are discussed in this chapter.