Reliability of Two Surgical Methods for Oroantral Communication Closure; A Clinical Study of 20 Patients

Abstract

Background/Purpose: Communication between the maxillary sinus and oral cavity, referred to as Oroantral Communication (OAC), is an uncommon complication in oral surgery and occurs mostly at the maxillary first molar, followed by the second molar, third molar, and bicuspid. Although smaller defects of <5 mm in diameter may close spontaneously, larger communications always require proper surgical closure techniques. In the present study, we evaluated the reliability of two OAC closure techniques. Material and methods: A total of 20 patients with OAC were selected for this study. The age, gender, location, size, and duration of the OAC and features of antral infection were recorded. Ten patients were treated with buccal advancement flaps, and 10 patients were treated with palatal rotation–advancement flaps. The results were assessed at 1 and 3 months postoperatively. All surgeries were performed by the same surgeon. Results: Of the 20 patients, 19 healed uneventfully. The donor site of the palatal flap was completely healed 3 months postoperatively, and grafts were not necessary. No flap necrosis was found in either group, with the exception of one patient who had undergone the Caldwell–Luc procedure and the palatal island flap technique. Conclusion: If OAC is not diagnosed and is managed improperly, there is a risk that an epithelialized permanent oroantral fistula and maxillary sinusitis may develop. The choice of closure procedure is influenced by not only the amount and condition of the tissue available for repair but also the size and location of the defect. It is important that the influence of various clinical parameters on the success rate be analyzed so that a proper technique can be applied to achieve successful closure of the defect.