A total of 20 patients with oroantral fistulae were selected for. 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. Saleh bakry assistant professor of oral and maxillofacial surgery 2. Pdf closure of oroantral fistula by using buccal fat pad. Review open access surgical options in oroantral fistula management. It is the purpose, therefore, of this paper to outline those modern. Various techniques have been examined for the closure of oroantral communications.
Clinical figure 1 and radiographic investigation figure 2 revealed oroantral communication in the vestibular ridge. Oroantral fistula synonyms, oroantral fistula antonyms. May 21, 2016 oroantral fistula introduction 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. Oroantral fistula oaf is an epithelialised oroantral communication oac. 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. Pdf communication between the maxillary sinus and oral cavity is. Aldren skip to main content accessibility help we use cookies to distinguish you from other users and to provide you with a better experience on our websites. Treatment plan has been explained to the patient, and preoperative medications were advised. Oroantral fistula definition of oroantral fistula by.
No treatment required as it will usually naturally heal. The clinical practice most frequently involves the mono. Treatment of chronic oroantral fistula with plateletrich fibrin clot and collagen membrane. Use of double layer technique for closure of oroantral. May 25, 2015 four month a go a sinus lift was performed and an oroantral communication and fistula was created. The oroantral fistula is a pathological connection between the maxillary sinus and. Case of oroantral communication closure using a pedicled buccal fat pad graft. It is of paramount importance to close the oroantral fistula in a disease free sinus environment. Antibiotics, oral care, nasal decongestants, and analgesics are recommended postoperatively. Surgical anatomy of maxillary sinus note on oroantral. To describe the main characteristics of the treatment techniques for. The suture must be situated over the acceptor site instead of the flap itself. Antibiotics, oral care, and analgesics are recommended postoperatively. Oac refers to an abnormal connection between the oral cavity and antrum or maxillary sinus.
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. Do you still have any of the same symptoms as before surgery. Oroantral communication followed by oroantral fistula oaf is a rare surgical complication in oral and maxillofacial surgery. Many chronic oroantral fistulas treated in the past could have been prevented had certain steps been taken immediately after their occurrence. Pdf closure of oroantral fistula by using buccal fat pad or. 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 premolars, iatrogenic complications or from dental infections, osteomyelitis, radiation therapy or trauma. Decisionmaking in closure of oroantral communication and fistula. C absorbable 40 catgut suture on the right maxillary sinus mucosa. Odontogenic sinusitis among patients surgically treated. Dona bhattacharya surgical anatomy of maxillary sinus note on oaf contents. Small oroantral fistulae treatment with systemic antibiotic drugs and daily rinses with chlorhexidine. 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. Oct 01, 2010 buccal advancement flap is a simple and easy to master technique to close oroantral fistula.
Learn more about oroantral fistula, sinus surgery, and postoperative instructions for closure of an oroantral fistula. Oroantral fistula free download as powerpoint presentation. Oroantral communication and fistula can occur as a result of inadequate and improper treatment. Management of oroantral communication using buccal advanced flap. Oroantral communication closure using a pedicled buccal fat. Did you have any early or late complications after the surgery. Surgical anatomy of maxillary sinus note on oroantral fistula.
Various surgical options pulkit khandelwal 1, neha hajira 2 abstract 2ur dqwudofrppxqlfdwlrqdqg. The palatal free end aspect was split into two layers and the deep periosteal layer was folded deep to. A crosssection of oroantral fistula in the molar region. There is a necessity for improvement in the manner in which these lesions are managed. There was no discharge from the fistula or any signs of acute infection. Its treatment involves removal of the oroantral fistula, surgery of the maxillary sinus and closure of the oroantral defect 1,2,5. Four month a go a sinus lift was performed and an oroantral communication and fistula was created. The results of surgery were considered good if the patient was free of symptoms such as nasal discharge, nasal obstruction, edema and facial pain and if an oroantral fistula had healed completely. The oroantral fistula is a solution of pathological continuity between the maxillary sinus and the oral cavity, frequently produced after a teeth extraction in most of cases of the first or second molars. Here you can read posts from all over the web from people who wrote about fistula and oroantral fistula, and check the relations between fistula and oroantral fistula. An oronasal fistula onf is defined as a communication between the oral and nasal cavities and occurs as a result of a defect in the gingival or palatal tissues and maxillary or incisive bone rostral to the third premolar. Treatment of oroantral fistula jama otolaryngologyhead. 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.
A total of 20 patients with oroantral fistulae were selected for this study. Oroantral fistula, ask a doctor about diagnosis, treatment. Please feel free to ask questions about any aspect of your care. Oroantral fistula article about oroantral fistula by the. Removal of maxillary molars may occasionally results in oro antral communication. The case was send it to us in order to repair and to build a. 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. Decisionmaking in closure of oroantral communication and. Alternative method to treat oroantral communication and. Surgery aims to promote ventilation and aeration of the maxillary sinus.
Prior to surgical treatment of oroantral communication, a previous diagnostic is achieved to exclude the presence of a foreign body andor inflammatory changes of the mucous membrane. Buccal fat pad flap in management of oroantral fistula of oroantral communications with bfp only, with a reported rapid mucosalization of the exposed fat in the oral cavity. Treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants, or by prosthodontics management. Full text treatment of chronic oroantral fistula with. Severe periodontal disease is the most common cause of. Oroantral communication closure using a pedicled buccal. The case was send it to us in order to repair and to build a new condition for the implant placement. First, we made an incision around the region of the fistula to collect the flap from the first plane figure 1c.
An oroantral fistula is a pathological condition in which. Case report a 34yearold man who was infected with hiv was referred to the medically compromised patient unit of the adelaide dental hospital for the management of an oroantral fistula. The treatment proposed was closure of oroantral fistula with vestibular flap. Oroantral fistula oaf is a relatively uncommon complication of maxillary molar extraction. Closure of oroantral communication using buccal advancement flap. Next, we made a vestibular incision up to tuberosity using the mesial plan to make a secondplan flap figure 1d. Treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants. Oro antral fistula it is an abnormal epithelized communication between maxillary sinus and oral cavity through perforation in the sinus wall 3. The closure of an oac of any origin can be achieved by different techniques. 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. Buccal flap, buccal pad of fat, oroantral fistula, palatal flap. The site of anastomosis should be free of tension and situated over intact alveolar bone.
Oroantral fistula definition of oroantral fistula by the. Treatment of oroantral fistula with autologous bone graft. All patients underwent a caldwellluc operation plus excision of the epithelium lining the fistula, that was then completely covered by a flap of mucosa rotated from the genian region. Nonsurgical management of an oroantral fistula in a.
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. Management of oroantral communication using buccal. We want you to have all of your questions answered and provide you with a complete understanding of your condition and treatment plan. 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. Introduction oac is a complication of surgery which result in a connection between oral cavity and maxillary sinus. Pictures and surgical repair of oroantral fistula, following upper molar extraction. 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 an overview sciencedirect topics. A late buccosinusal fistula in the 1516 tooth area. B circular incision around the fistula and mucosa displacement on the fistulous path.
Local and distant flaps as well as combination of flaps can be used for closure of oaf. Modern management of oroantral fistula jama otolaryngology. The oroantral fistula has its origin either from iatrogenic complications or from dental infections, trauma, radiation therapy, or osteomyelitis 1. The closure of an oroantral communication of any origin, can be achieved by different techniques. The aim of this study was to compare the clinical outcomes of buccal fat pad flap or buccal advancement flap in closure of the oroantral fistula. 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. Treatment modalities to repair the oroantral defects include local or free soft tissue flaps, with or without autografts or alloplastic materials. Various options available for the surgical management of oroantral fistula are as given below flaps.
An oroantral fistula can occur as the consequence of a postoperative acute sinusitis or of a sinusal mucosa perforation sequent to implants placement 19,20 fig. The commonest symptom provoked is an acute sinusitis evolving to chronicity if the fistula remains. Treatment of oroantral fistula a study debrided up to the well perfused tissue, and the infected bone should be curetted. Pdf surgical options in oroantral fistula treatment.
494 1499 998 419 1086 116 871 175 227 791 1106 32 782 298 685 1316 418 329 233 471 39 1063 1161 1210 366 678 836 1194