Closure of oro-antral communications

What is an Oro-Antral Communication

An oro-antral communication is a condition that can arise after a dental extraction procedure.

The air-filled spaces that sit behind the cheeks and on the top of the upper jaw are known as maxillary sinuses (antrum). In some cases, large tooth roots of the upper molars can extend beyond the jawbone and into the sinus cavity. If an upper molar extraction is required, a hole can remain that connects the mouth (oro) and the antrum, to make an oro-antral communication.

If an oro-antral communication fails to heal by itself, it can develop into an oro-antral fistula. This is where the sinus lining and the gum in the mouth form together into a tunnel that is susceptible to bacterial infection and inhibits healing. An oro-antral communication requires surgery to close.

Symptoms of Oro-Antral Communication

Oro-antral communication symptoms range depending on the size of the communication. Typically, pain can be experienced for several weeks after an upper molar extraction. Some symptoms include:

  • an empty (non-healing) socket;
  • initial pain or ongoing pain related to an infection;
  • air or fluid from the nose into the mouth;
  • food or fluid from the mouth up into the nose;
  • sinusitis;
  • pain and tenderness in the upper cheek;
  • blocked nostril and discharge.

Several factors can put patients at risk of developing oro-antral communication after extraction. These include patients with large or ill-shaped upper molar roots, large sinuses, dry socket, complex extractions, infection, abscesses, cysts, periodontal disease and older age.

What Oro-Antral Communication Treatments Exist

Oro-Antral Communication treatments can vary, depending on the location or size of the communication and presence of epithelium (thin tissue).

Existing sinus diseases can complicate a procedure and will require antibiotics preoperatively along with adequate nasal drainage to remove infection. A procedure is then performed to close the connection, involving a flap of soft tissue being lifted and stretched across the socket to cover the hole. The tissue is then stitched in place, ready for healing.

For more information on the closure of oro-antral communications, please contact PM Oral Surgery on 9745 4066 or complete a contact us form.

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