Surgical options in oroantral fistula management: a narrative review

Puria Parvini,Frank Schwarz,Loutfi Salti,Robert Sader,Jürgen Becker,Karina Obreja

doi:10.1186/s40729-018-0152-4

Abstract

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. With the presence of a fistula, the maxillary sinus is permanently open. Microbial flora passes from the oral cavity into the maxillary sinus, and the inflammation of the sinus occurs with all potential consequences. In literature, various techniques have been proposed for closure of OAFs. Due to the heterogeneity of the data and techniques found, we opted for a narrative review to highlight the variety of techniques discussed in the literature. Techniques of particular interest include the bone sandwich with resorbable guided tissue regeneration (GTR) membrane and platelet-rich fibrin (PRF) used alone as both a clot and a membrane. The great advantage of these techniques is that no donor site surgery is necessary, making the outcome valuable in terms of time savings, cost and, more importantly, less discomfort to the patient. Additionally, both bony and soft tissue closure is performed for OAF, in contrast to flaps, which are typically used for procedures in the sinus area. The reconstructed bony tissue regenerated from these techniques will also be appropriate for endosseous dental implantation.

Highlights

An oroantral fistula (OAF) can be defined as an epithelialized pathological unnatural communication between the oral cavity and the maxillary sinus [1]
Summary and conclusion By reviewing the literature, we can conclude that in selecting the surgical approach to close an oroantral fistula, different parameters have to be taken into account, including location and size of fistula as well as its relationship to the adjacent teeth, height of the alveolar ridge, persistence, sinus inflammation and the general health of the patient
The closure of an oroantral fistula can be performed by different techniques

Summary

Introduction

An oroantral fistula (OAF) can be defined as an epithelialized pathological unnatural communication between the oral cavity and the maxillary sinus [1]. 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 [2]. They can arise as late sequelae from perforation and last at least 48–72 h. Studies reported sexual dimorphism in oroantral fistula, with males showing more frequency than females [1, 4]. This difference can be Clinically, the patient may experience one or more disturbances which draw attention to the oroantral fistula. Pain, foul or salty taste, alteration in voice resonance, inability to blow out the cheeks, air shooting from the fistula into the mouth when blowing the nose, and escape of liquids from the mouth through the nose [5]

Methods

Findings

Discussion

Conclusion