Guidelines

How is oral antral communication treated?

How is oral antral communication treated?

All patients should receive amoxicillin plus clavulanic acid (Augmentin/Amoxyclav), 1 g twice daily, or clindamycin, 300 mg 3 times daily for at least 5 days, and a decongestant nasal drops (Otrivin 0.05%). Nasal decongestants shrink the nasal mucosa and keep the antral opening patent for drainage.

How are oral antral fistula treated?

Treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants.

How long does OAC take to heal?

This is a painless procedure and is carried out under local anaesthetic (numbing injection into the gum). You will have some dissolving stitches placed to hold the gum in its new position to cover the hole whilst it heals underneath. These stiches will be removed if they haven’t otherwise dissolved in 14 days.

How long does it take a sinus communication to heal?

Sinus communication: A sinus communication occurs when a very small hole is made in your sinus lining. Sinus communications are the most commonly experienced side effect of a root canal. These holes are so small they often heal on their own, taking about 2-3 days to fully heal before you are symptom-free.

Can sinus communication heal on its own?

If your sinus communication is small, it will heal on its own, and you will not have to seek further treatment. However, if your pain and discomfort persists or gets worse, you may have a larger hole in your sinus lining, and you may need treatment to close this opening.

Is oroantral communication painful?

An oroantral communication itself causes little or no discomfort but usually induces a degree of sinusitis. The nature and distribution of pain and presence of nasal discharge are typical of sinusitis.

How do you test for oral antral communication?

The establishment of oroantral communication can be confirmed by the Valsalva method. The patient is instructed to expel air against closed nostrils, while the clinician checks if air hisses from the fistula into the mouth. A hissing noise from air leakage through the maxillary sinus and nose indicates a positive test.

What causes oroantral communication?

An oroantral communication (OAC) is an unnatural space that forms between the maxillary sinus and oral cavity following extraction of antral teeth, infection, or several different complications. If left untreated, an OAC can develop into an oroantral fistula (OAF) or chronic sinus disease.

How is OAC diagnosed?

Depending on the size of the potential communication and in what context, a small radiograph inside the mouth may be sufficient (a periapical) to assess for any break in the bone of the sinus floor which may indicate an OAC. – Panoramic radiographs can also be used to confirm the presence of an OAC.

How is dental sinusitis treated?

What is the treatment for a dental sinus? Removal of the entire tooth (extraction) or necrotic dental pulp (root canal / endodontic treatment) is the only successful treatment for a dental sinus. Antibiotics such as penicillin or metronidazole may be also required.

How common is an oroantral communication?

Up to 10% of upper molar extractions may create oroantral communications, but very few, only 0.5%, persist to become fistulae. Other causes include malignant neoplasms arising in the oral cavity or in the antrum.

What causes sinus communication?

The sinus lining is very close to the root of your back teeth. This lining is quite delicate, so in some surgeries, like tooth extractions and root canals, it’s possible that the sinus lining may accidentally be punctured. This creates a sinus communication.

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