Abstract
Background and Objectives: Smoking has been found to interfere with wound healing processes. Therefore, the purpose of this study was to compare surgical treatment of oroantral fistulae (OAFs) in smokers and non-smokers. Materials and Methods: Medical records of all consecutive patients who underwent surgical closure of OAFs between 2003 and 2016 at the oral and maxillofacial surgery department, Rabin Medical Center, Israel were reviewed. Patients’ demographic data, preoperative signs and symptoms, surgical method of repair, and postoperative complications were recorded. Results: The cohort consisted of 38 smokers and 59 non-smokers. Age and gender distributions were similar in both groups. The main etiology in both groups was tooth extraction, followed by pre-prosthetic surgery in smokers and odontogenic infection in non-smokers (p = 0.02). Preoperative conditions were not significantly different between smokers and non-smokers in terms of size of soft tissue fistula and bony defect, chronic sinusitis and foreign bodies inside the sinus. OAFs were repaired by local soft tissue flaps without consideration of smoking status. Smokers experienced more moderate-severe postoperative pain (p = 0.05) and requested more weak opioids (p = 0.06). Postoperative complications included infection, delayed wound healing, residual OAF, pain, sensory disturbances and sino nasal symptoms. These were mostly minor and tended to be more frequent in smokers (p = 0.35). Successful closure of OAFs was obtained in all patients except one smoker who required revision surgery. Conclusions: Smokers may be more susceptible to OAFs secondary to preprosthetic surgery. In this cohort, there was no statistically significant difference in outcome between smokers and non-smokers in terms of failure. However, smokers tended to have more severe postoperative pain and discomfort and to experience more postoperative complications. Further studies with larger sample sizes should be conducted to validate these results.
Highlights
Oroantral fistulae (OAFs) are pathological tracts connecting the oral cavity and maxillary sinus.These communications are usually iatrogenic, secondary to surgical procedures in the posterior maxilla, such as tooth extraction, sinus augmentation and dental implants (Figure 1), but may result from pathology or trauma [1,2,3].Small oroantral communications (OACs), up to 3 mm, tend to heal spontaneously by secondary healing
Larger communications (>3 mm), and those accompanied by inflammation, usually require surgical closure to prevent epithelialization and formation of chronic oroantral fistulae (OAFs) [1,3,4,5,6,7,8]
The aim of the present study was to compare the outcome of surgical treatment of OAFs in smokers and non-smokers
Summary
Oroantral fistulae (OAFs) are pathological tracts connecting the oral cavity and maxillary sinus.These communications are usually iatrogenic, secondary to surgical procedures in the posterior maxilla, such as tooth extraction, sinus augmentation and dental implants (Figure 1), but may result from pathology or trauma [1,2,3].Small oroantral communications (OACs), up to 3 mm, tend to heal spontaneously by secondary healing. Oroantral fistulae (OAFs) are pathological tracts connecting the oral cavity and maxillary sinus. These communications are usually iatrogenic, secondary to surgical procedures in the posterior maxilla, such as tooth extraction, sinus augmentation and dental implants (Figure 1), but may result from pathology or trauma [1,2,3]. Larger communications (>3 mm), and those accompanied by inflammation, usually require surgical closure to prevent epithelialization and formation of chronic OAFs [1,3,4,5,6,7,8]. Materials and Methods: Medical records of all consecutive patients who underwent surgical closure of OAFs between 2003 and 2016 at the oral and maxillofacial surgery department, Rabin Medical Center, Israel were reviewed. Patients’ demographic data, preoperative signs and symptoms, surgical method of repair, and postoperative complications were recorded
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