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. Management of oroantral fistula and related surgical. Fibrosis sets in within the clot material aiding the healing process. Treatment of oacs identified in their early stages is based on a surgical procedure that provides adequate communication closure and the correct patient. Oroantral fistula oaf is an epithelialised oroantral communication oac. Closure of oroantral fistula with buccal fat pad flap and. 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. It is usually associated with maxillary sinusitis, where drainage of sinus infection is a mandatory step during closure of the fistula.
Consequently, it requires a combination of knowledge, experience, and information gathering. 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. Shivani sachdeva abstract various options are available for the surgical management of oroantral fistulae however postoperative wound. Use of double layer technique for closure of oroantral fistula our experience. Use of palatal rotation flap in the closure of oroantral. The buccal and palatal mucoperiosteal flap is raised but not mobilised for advancement.
Oroantral fistula oaf is a relatively uncommon complication of maxillary molar extraction. The upper lateral teeth when removed has a tendency to form blood clots. Local and distant flaps as well as combination of flaps can be used for closure of oaf. For the closure of oroantral fistula, many techniques have been described. The usual pathogens associated with various head and neck infections and their. To show a case report of oroantral fistula and its closure. 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 aims of this study are to describe and compare the three most common techniques employed in surgical closure of oroantral fistulas. Repair oroantral fistula otolaryngology coding ask an. Site sutured after closure palatal tissue healing 24. Previous narrative research has focused on assessments and comparisons of various surgical techniques for the closure of oacoaf. Treatment modalities for oroantral fistula oaf closure. Oroantral fistula definition of oroantral fistula by.
References andrea enrico borgonovo, frederick valerio berardinelli, marco favale, carlo maiorana. This is a fistulous communication between the floor of the maxillary sinus to the oral cavity. 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. Closure of oroantral fistula international journal of oral and. A rotational flap of the buccal mucosa was then elevated with the bovieelectrocautery device. Comparative study, authorahmad al nashar and hasan m. Chronic oroantral fistula may complicate into chronic sinusitis and its sequelae. The oroantral communication is a term includes the oroantral fistula in addition to. Closure of oroantral communication using buccal fat pad.
Acute and chronic oroantral fistula and sinusitis can occur as a result of inadequate treatment. 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. Terry pannkuk, dds, mscd shows the microsurgical repair of an oroantral fistula that developed after an extraction. Pdf closure of oroantral fistula by using buccal fat pad. Oroantral fistula closure an oroantral fistula will not heal spontaneously and must be surgically repaired. There are advantages and disadvantages of all these techniques. The healing of the wound and closure of the defect could be seen after a 30day postoperative period, with complete epithelialization. Oroantral fistula is an uncommon complication in oral surgery. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. Autogenous closure of oroantral comunication juniper publishers. 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. Alloplastic materials such as tantalum, gold plates and foils, hydroxyapatite blocks have been used for closure of oroantral fistula oaf. The decisionmaking in closure of oroantral communication and fistula is influenced by many factors. Success was accessed by complete closure of communication or fistula.
Grafting of the pedicled buccal fat pad is thought to be an efficient, safe and easy alternative to a larger oroantral fistula closure. Decisionmaking in closure of oroantral communication and fistula. 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. These findings thus correlate with those made by obwegeser a and tschamer 1957 and by killey. Early treatment of oac is very important to prevent formation of an oroantral fistula oaf, to avoid development of chronic maxillary sinusitis, and. The suggested algorithm for the treatment of oaf is illustrated in fig.
Various options available for the surgical management of oroantral fistula are as given below flaps. In the past few decades, an extensive pool of literature has developed pertaining to surgical closure of the oaf. This commonly occurs following dental extraction of infected upper molar and premolar tooth. The objective of the study was to determine the most vulnerable sites and side involved in oroantral fistula creation. Oaf could be caused by dental infection, osteomyelitis, radiation therapy, trauma or following removal of maxillary cysts or tumors. The present article shows a clinical case of the closing of oroantral. Decisionmaking in closure of oroantral communication and. Marta del rey santamaria, eduard valmaseda castellon. Use of double layer technique for closure of oroantral. The flap used for closure of oaf should be tension free, broadly based and well vascularized. Oroantral communication and fistula linkedin slideshare.
Oroantral fistula oaf is a pathologic communication between the oral cavity and the maxillary sinus. Haas r, watzak g, baron m 2003 a preliminary study of monocortical bone grafts for oroantral fistula closure. The patients with acute oac underwent operation immediately. Oroantral communication closure using a pedicled buccal. 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. 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 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. However, these materials are not widely accepted in routine surgical closure of oaf due to cost, difficult handling, increased rate of infection, and exfoliation. The bony fragment itself was then debrided back to healthy bleeding tissue. Pdf closure of oroantral fistula with pedicled buccal. Primary closure of a sinus perforation primary closure of a sinus perforation is indicated for large. Management of oroantral fistula linkedin slideshare. L treatment of oroantral fistula by gold foil closure. The most common causes of complications include inadequate site preparation, flap closure, flap necrosis, infection, and patient non.
An oroantral communication oac is an open con nection between the oral. Pdf decisionmaking in closure of oroantral communication and. Various surgical options pulkit khandelwal 1, neha hajira 2 abstract 2ur dqwudofrppxqlfdwlrqdqg. Oroantral communication oac acts as a pathological pathway for bacteria and can cause infection of the antrum, which further. Closure of oroantral fistula 59 or the caldwellluc procedure. Various techniques have been examined for the closure of oroantral communications. Furthermore, improper treatment of oac can produce maxillary sinusitis and become chronic 8. They can arise as late sequelae from perforation and last at least 4872 h. Oroantral communication and fistula can occur as a result of inadequate and improper treatment. Through the fistula itself, a marked amount of thickened mucosa was stripped out and removed. Buccal fat pad for closure of oroantral and oronasal. Closure of oroantral communication using guided tissue. Closure of oroantral fistula using titanium plate with.
Oroantral fistula mouth human head and neck free 30. Saleh bakry assistant professor of oral and maxillofacial surgery 2. Palatal flap ant titanium mesh for oroantral fistula closure. 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. Closure of oroantral fistula by using buccal fat pad or buccal advancement flap. Oac refers to an abnormal connection between the oral cavity and antrum or maxillary sinus. Chronic oac were treated after irrigation with saline. Oro antral fistula it is an abnormal epithelized communication between maxillary sinus and oral cavity through perforation in the sinus wall 3. Oroantral fistula an overview sciencedirect topics.
Alternative surgical management of oroantral fistula using auricular cartilage. The aim of this study was to assess the effectiveness of closure. To overcome the above drawbacks this study aimed to use titanium plates 0. We present a technique in which nasoseptal cartilage graft is used for the closure of the oroantral. 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.
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