scholarly journals ROTAÇÃO DE RETALHO PALATINO COMO ALTERNATIVA DE TRATAMENTO PARA FÍSTULA BUCOSSINUSAL

2019 ◽  
Author(s):  
Eugênio Braz Rodrigues Arantes
Keyword(s):  
Maxillary Sinus ◽  
Oral Surgery ◽  
Maxillary Sinusitis ◽  
Direct Path ◽  
Surgical Time ◽  
Oroantral Fistula ◽  
Common Causes ◽  
Anatomical Relationship ◽  
Relationship Of ◽  
Keratinized Mucosa

ResumoA fístula ou comunicação bucossinusal consiste na formação de um trajeto direto entre a cavidade oral e o seio maxilar diagnosticada tardiamente após epitelização da mucosa formando um canal bucossinusal permanente. Na maioria das vezes, essa complicação ocorre em função da relação anatômica do seio maxilar intimamente relacionado com o ápice das raízes dos dentes superiores posteriores. Procedimentos cirúrgicos inadequados relacionados à exodontia dos elementos dentários envolvidos ou extensa pneumatização do seio maxilar podem ser as causas mais comuns dessa patologia. O objetivo do presente trabalho é apresentar um relato de caso clínico de uma fístula bucossinusal pós exodontia e não corrigida imediatamente, tratada através de retalho mucoso palatino vascularizado e rotacionado para fechamento primário. A técnica do retalho palatino mostrou-se uma opção favorável para o fechamento do defeito sinusal em um único tempo cirúrgico, preservando a mucosa queratinizada e a anatomia do sulco vestibular.Palavras-chave: Seio maxilar, sinusite maxilar, fístula bucoantral, cirurgia bucal.AbstractThe bucosinusal fistula or communication consists in the formation of a direct path between the oral cavity and the maxillary sinus diagnosed late after epithelialization of the mucosa forming a permanent bucosinusal canal. Most often, this complication occurs due to the anatomical relationship of the maxillary sinus closely related to the apex of the roots of the posterior superior teeth. Inadequate surgical procedures related to the extraction of the involved dental elements or extensive pneumatization of the maxillary sinus may be the most common causes of this pathology. The aim of the present study is to present a case report of an immediately uncorrected post-extraction bucosinusal fistula treated with a vascularized palatine mucous flap and rotated for primary closure. The palatal flap technique proved to be a favorable option for closing the sinus defect in a single surgical time, preserving the keratinized mucosa and the buccal sulcus anatomy.Key-words: Maxillary sinus, maxillary sinusitis, oroantral fistula, oral surgery.

scholarly journals Chronic Maxillary Sinusitis Caused by Denture Lining Material

2016 ◽  
Vol 10 (1) ◽  
pp. 261-267
Author(s):  
Tsutomu Sugiura ◽  
Kazuhiko Yamamoto ◽  
Chie Nakashima ◽  
Kazuhiro Murakami ◽  
Yumiko Matsusue ◽  
...  
Keyword(s):  
Foreign Body ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Second Molar ◽  
Oroantral Fistula ◽  
Good Shape ◽  
Posterior Maxilla ◽  
Lining Material ◽  
Chronic Maxillary Sinusitis ◽  
The Right

We report a case of chronic maxillary sinusitis caused by denture lining material entering through an oroantral fistula after tooth extraction. The patient was an 80-year-old female who visited us with a complaint of pus discharge from the right posterior maxilla. She had extraction of the upper right second molar and had her upper denture relined with silicone lining material. The patient noticed swelling of the right cheek and purulent rhinorrhea 20 days before her first visit to our clinic. Oral examination showed an oroantral fistula with a diameter of 3 mm in the posterior alveolar ridge of the right maxilla. Computed tomography revealed a hyperdense foreign body in the right maxillary sinus and thickening of the mucosal lining. Under diagnosis of maxillary sinusitis caused by a foreign body, endoscopic maxillary surgery was performed simultaneously with the removal of the foreign body. The foreign body removed was 12 × 6 mm in size, oval in shape, light pink in color, and compatible with silicone denture lining material. During the follow-up it was observed that the oroantral fistula closed spontaneously after the removal of the foreign body. The maxillary sinus was in a good shape without recurrence of sinusitis seven months after surgery.

scholarly journals Chronic Maxillary Sinusitis Associated with an Unusual Foreign Body: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Yunus Feyyat Şahin ◽  
Togay Muderris ◽  
Sami Bercin ◽  
Ergun Sevil ◽  
Muzaffer Kırıs
Keyword(s):  
Foreign Body ◽  
Maxillary Sinus ◽  
Foreign Bodies ◽  
Maxillary Sinusitis ◽  
Surgical Removal ◽  
Oroantral Fistula ◽  
Unusual Foreign Body ◽  
Dental Procedures ◽  
Chronic Maxillary Sinusitis ◽  
Left Maxillary Sinus

Foreign bodies in maxillary sinuses are unusual clinical conditions, and they can cause chronic sinusitis by mucosal irritation. Most cases of foreign bodies in maxillary sinus are related to iatrogenic dental manipulation and only a few cases with non-dental origin are reported. Oroantral fistulas secondary to dental procedures are the most common way of insertion. Treatment is surgical removal of the foreign body either endoscopically or with a combined approach, with Caldwell-Luc procedure if endoscopic approach is inadequate for visualisation. In this case, we present a 24-year-old male patient with unilateral chronic maxillary sinusitis due to a wooden toothpick in left maxillary sinus. The patient had a history of upper second premolar tooth extraction. CT scan revealed sinus opacification with presence of a foreign body in left maxillary sinus extending from the floor of the sinus to the orbital base. The foreign body, a wooden toothpick, was removed with Caldwell-Luc procedure since it was impossible to remove the toothpick endoscopically. There was no obvious oroantral fistula in the time of surgery, but the position of the toothpick made us to think that it was inserted through a previously healed fistula, willingly or accidentally.

Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use

2019 ◽  
Vol 33 (5) ◽  
pp. 500-506 ◽  
Author(s):  
Chi Sang Hwang ◽  
Chunui Lee ◽  
Hee Sung Chae ◽  
Chun Han ◽  
Hyun Woo Yang ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Chronic Rhinosinusitis ◽  
Single Photon ◽  
Maxillary Sinusitis ◽  
Photon Emission ◽  
Clinical Manifestations ◽  
Clinical Appearance ◽  
Oroantral Fistula ◽  
History Of

Background Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus. Objective Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use. Methods Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis. Results Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3%) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8%) and bony remodeling in the posterior maxillary region (90.5%). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5%) and 12 patients (50.0%) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects. Conclusions Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations.

scholarly journals PLASMA RICO EM FIBRINA (PRF) COMO OPÇÃO DE RECOBRIMENTO APÓS ROTAÇÃO DE RETALHO PALATINO PARA TRATAMENTO DE FÍSTULA BUCOSSINUSAL

2020 ◽  
Author(s):  
Rafael Mérola Corrêa
Keyword(s):  
Clinical Case ◽  
Oral Surgery ◽  
Maxillary Sinusitis ◽  
Platelet Rich Fibrin ◽  
Mucosal Flap ◽  
Oroantral Fistula ◽  
Donor Area ◽  
Chronic Maxillary Sinusitis ◽  
Autogenous Grafts ◽  
Fibrin Membrane

ResumoO desenvolvimento de uma fístula bucossinusal, a partir de uma comunicação gerada entre a cavidade oral e o seio maxilar, pode ser favorecido por um não fechamento espontâneo ou por uma sinusite maxilar crônica já instalada. O tratamento da fístula bucossinusal depende de fatores que podem beneficiar ou dificultar o prognóstico dos casos, como a localização, causa e o tamanho do defeito gerado. Diferentes técnicas são descritas na literatura para o tratamento destes defeitos orosinusais, como retalhos locais deslizantes ou rotacionados, enxertos autógenos ou o uso da bola de gordura bucal.  O objetivo do presente trabalho é apresentar o caso clínico de uma fístula bucossinusal pós exodontia há aproximadamente 05 anos, não corrigida imediatamente, tratada através de retalho mucoso palatino rotacionado. Como coadjuvante para a cicatrização da área doadora foi utilizado membrana de fibrina rica em plaquetas. A técnica do retalho palatino mostrou-se uma opção favorável para o fechamento da fístula bucossinusal e o uso dos fatores de crescimento permitiu vascularização adequada na área doadora e no retalho rotacionado, o que favoreceu a hemostasia vascular e estimulou a recuperação dos tecidos moles adjacentes.Palavras-chave: Seio maxilar, fístula bucoantral, cirurgia bucal, fibrina rica em plaquetas.          AbstractThe development of a bucosinusal fistula from a communication generated between the oral and maxillary cavity may be favored by a spontaneous unblocked or an existing chronic maxillary sinusitis. The treatment of bucosinusal fistula depends on factors that may benefit or hinder the prognosis of cases, such as location, cause and size of the defect used. Different techniques are described in the literature for the treatment of these oral defects, such as sliding or rotating local flaps, autogenous grafts or the use of the buccal fat ball. The aim of the present study is to present the clinical case of a post-extraction bucosinusal fistula approximately 05 years ago, not immediately corrected, treated through a rotated palatal mucosal flap. As an adjunct to the healing of the donor area, a platelet-rich fibrin membrane was used. The palatal flap technique proved to be a favorable option for the closure of the bucosinusal fistula and the use of growth factors allowed adequate vascularization in the donor area and in the rotated flap, which favored vascular hemostasis and stimulated the recovery of adjacent soft tissues.Key-words: Maxillary sinus, oroantral fistula, oral surgery, platelet-rich fibrin  

scholarly journals Oral surgery as risk factor of odontogenic maxillary sinusitis

2006 ◽  
Vol 134 (5-6) ◽  
pp. 191-194 ◽  
Author(s):  
Alek Racic ◽  
Jelena Dotlic ◽  
Ljiljana Janosevic
Keyword(s):  
Foreign Bodies ◽  
Oral Surgery ◽  
Pathological Condition ◽  
Maxillary Sinusitis ◽  
Common Cause ◽  
Oroantral Fistula ◽  
Pathological Conditions ◽  
Odontogenic Sinusitis ◽  
Oroantral Communication ◽  
Upper Molar

In order to determine the risk factors of odontogenic maxillary sinusitis, a total number of 40 patients with this pathological condition was examined in three-year period. Oroantral communication was detected in 40% of patients, oroantral fistula in 25%, sinus foreign bodies in 15% and other pathological conditions in 10% of cases. The extraction of the upper lateral teeth was the cause of odontogenic sinusitis in 65% patients. Given the specific tooth, the first upper molar was the most common cause of the condition, i.e. in 40% of cases. It may be concluded that odontogenic sinusitis is the complication of the oral cavity surgery in 85% of patients, what should be taken into consideration in prevention.

PLASMA RICO EM FIBRINA (PRF) COMO OPÇÃO DE RECOBRIMENTO APÓS ROTAÇÃO DE RETALHO PALATINO PARA TRATAMENTO DE FÍSTULA BUCOSSINUSAL

2020 ◽  
Author(s):  
Rafael Mérola Corrêa
Keyword(s):  
Clinical Case ◽  
Oral Surgery ◽  
Maxillary Sinusitis ◽  
Platelet Rich Fibrin ◽  
Mucosal Flap ◽  
Oroantral Fistula ◽  
Donor Area ◽  
Chronic Maxillary Sinusitis ◽  
Autogenous Grafts ◽  
Fibrin Membrane

ResumoO desenvolvimento de uma fístula bucossinusal, a partir de uma comunicação gerada entre a cavidade oral e o seio maxilar, pode ser favorecido por um não fechamento espontâneo ou por uma sinusite maxilar crônica já instalada. O tratamento da fístula bucossinusal depende de fatores que podem beneficiar ou dificultar o prognóstico dos casos, como a localização, causa e o tamanho do defeito gerado. Diferentes técnicas são descritas na literatura para o tratamento destes defeitos orosinusais, como retalhos locais deslizantes ou rotacionados, enxertos autógenos ou o uso da bola de gordura bucal.  O objetivo do presente trabalho é apresentar o caso clínico de uma fístula bucossinusal pós exodontia há aproximadamente 05 anos, não corrigida imediatamente, tratada através de retalho mucoso palatino rotacionado. Como coadjuvante para a cicatrização da área doadora foi utilizado membrana de fibrina rica em plaquetas. A técnica do retalho palatino mostrou-se uma opção favorável para o fechamento da fístula bucossinusal e o uso dos fatores de crescimento permitiu vascularização adequada na área doadora e no retalho rotacionado, o que favoreceu a hemostasia vascular e estimulou a recuperação dos tecidos moles adjacentes.Palavras-chave: Seio maxilar, fístula bucoantral, cirurgia bucal, fibrina rica em plaquetas.          AbstractThe development of a bucosinusal fistula from a communication generated between the oral and maxillary cavity may be favored by a spontaneous unblocked or an existing chronic maxillary sinusitis. The treatment of bucosinusal fistula depends on factors that may benefit or hinder the prognosis of cases, such as location, cause and size of the defect used. Different techniques are described in the literature for the treatment of these oral defects, such as sliding or rotating local flaps, autogenous grafts or the use of the buccal fat ball. The aim of the present study is to present the clinical case of a post-extraction bucosinusal fistula approximately 05 years ago, not immediately corrected, treated through a rotated palatal mucosal flap. As an adjunct to the healing of the donor area, a platelet-rich fibrin membrane was used. The palatal flap technique proved to be a favorable option for the closure of the bucosinusal fistula and the use of growth factors allowed adequate vascularization in the donor area and in the rotated flap, which favored vascular hemostasis and stimulated the recovery of adjacent soft tissues.Key-words: Maxillary sinus, oroantral fistula, oral surgery, platelet-rich fibrin  

scholarly journals Odontogenic Maxillary Sinusitis: Therapeutic Management of Cases with Oroantral Fistulae

Sinusitis ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 53-58
Author(s):  
Yasutaka Yun ◽  
Masao Yagi ◽  
Tomofumi Sakagami ◽  
Shunsuke Sawada ◽  
Yuka Kojima ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Surgical Intervention ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Fistula Closure ◽  
Treatment Resistant ◽  
Oroantral Fistula

Odontogenic maxillary sinusitis (OMS) is a disease in which inflammation from the teeth extend into the maxillary sinus, causing symptoms of unilateral sinusitis. OMS can recur, with some being resistant to antibiotics. In intractable cases, exodontia and endoscopic sinus surgery (ESS) are necessary treatments. Here we report our analysis on the indications for surgical intervention in cases diagnosed with and treated as OMS. We retrospectively examined 186 patients who were diagnosed with sinusitis on a computed tomography (CT) scan. For cases diagnosed with OMS, the site of the causative tooth and the presence or absence of oroantral fistula to the maxillary sinus was examined. In addition, we analyzed the therapeutic efficacy of the initial treatment of antibiotics, and what the indications were for ESS. Among the patients examined, OMS was diagnosed in 44 cases (23.6%). In 14 out of 20 cases that underwent a post-medical treatment CT scan, OMS found to be treatment-resistant. Of these 14 cases, 12 (88%) had oroantral fistulae to the maxillary sinus. In all cases where exodontia, fistula closure surgery, and endoscopic sinus surgery (ESS) were performed, the fistula disappeared and the shadow of inflammation in the paranasal sinus improved. In OMS with oroantral fistula, ESS, exodontia, and fistula closure should be recommended over medication such as macrolide therapy.

scholarly journals Microbial landscape and immune status in maxillary sinusitis of stomatogenic origin

2021 ◽  
Vol 26 (3) ◽  
pp. 145-151
Author(s):  
I.V. Kovach ◽  
S.D. Varzhapetian ◽  
Kh.A. Bunyatyan ◽  
O.E. Reyzvikh ◽  
A.A. Babenya ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Venous Blood ◽  
Allergic Sensitization ◽  
Microbial Flora ◽  
Total Serum ◽  
Gram Positive ◽  
Oroantral Fistula ◽  
Gram Positive Cocci

Oroanthral fistula (anastomosis) is an element preventing the restoration of homeostasis in the maxillary sinus due to the constant flow of microbes from the oral cavity. It is also contributes to frequent exacerbations of maxillary sinusitis. Saprophytic gram-positive cocci and fungi of the oral cavity are dominating representatives of the microbial flora in the maxillary sinus. As the result of research, we found that in the case of maxillary sinusitis with oroantral fistula fungi made up 25.0% of microbiota, gram-positive bacteria – 41.7%, gram-negative bacteria – 33.3%. Gram-positive cocci from the Staphy­lococcus genus (Staphylococcus aureus and Staphylococcus epidermidis) and fungi (Candida albicans) comprised the biggest proportion of microbial flora that 33.3% and 16.7%, respectively. Slightly decreased levels of monocytes in venous blood was noted in 69.2% of patients. The average value of total serum IgE in group with oroantal fistula was 226.2 (70.4) IU/ml, the result exceeded normal limits almost in 2.26 times. Large circulating immune complexes (CICs) were normal in all patients in the group with iatrogenic maxillary sinusitis. The average lavels of small size CICs was 170.2 (4.23) ОU, which is in 1.06 times higher the upper limit of the norm (160 ОU). Elevated levels of total Ig E in serum of patients with oroanthral fistula indicates allergic sensitization. The detection of increased levels of CICs with small and medium sizes in serum may indicate a susceptibility of this category of patients to the development of immunopathological reactions.

scholarly journals Closure of large oroantral fistula with resorbable collagen membrane: Case report

2009 ◽  
Vol 56 (4) ◽  
pp. 201-206 ◽  
Author(s):  
Aleksa Markovic ◽  
Snjezana Colic ◽  
Radojica Drazic ◽  
Ljiljana Stojcev ◽  
Bojan Gacic
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Collagen Membrane ◽  
Oroantral Fistula ◽  
Chronic Maxillary Sinusitis

Oroantral fistula is pathologic communication between oral cavity and maxillary sinus, usually localized between antrum and buccal vestibulum. Persisting OAF always causes chronic maxillary sinusitis. A technique for closure of a large oroantral fistula with resorbable collagen membrane is described.

scholarly journals Maxillary sinus implant removal: modified Caldwell-Luc technique

2020 ◽  
Vol 9 (9) ◽  
pp. e901997936
Author(s):  
Juceléia Maciel ◽  
Albanir Gabriel Borrasca ◽  
Leonardo Alan Delanora ◽  
Maria Eloise de Sá Simon ◽  
Nathália Januario de Araújo ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Lateral Wall ◽  
Oral Rehabilitation ◽  
Second Molar ◽  
Oroantral Fistula ◽  
Bone Window ◽  
Close Relationship ◽  
Immediate Implants ◽  
Immediate Implant

The installation of immediate implants after tooth extractions is becoming a common practice in the dental clinic. During this surgical procedure, complications such as the displacement of dental implants into the maxillary sinus may occur due to the close relationship between the floor of the maxillary sinus and the upper teeth. In these cases, treatment consists of removing the implant that has been displaced in order to prevent future complications such as maxillary sinusitis and oroantral fistula. The present study aims to present a clinical case in which the removal of the maxillary sinus implant was performed using the modified Caldwell-Luc Technique. The patient sought a private clinic for extraction of the left upper second molar and oral rehabilitation with implants. Even with little bone height between the floor of the maxillary sinus and the crest of the alveolar ridge, the professional opted for immediate implant installation after extraction, but when returning after 90 days, the implant had moved into the sinus. The implant was removed using the modified Caldwell-Luc technique, which consists of making a bone window in the lateral wall of the maxillary sinus, removing the fragment, replacing the bone window, and suturing the previously folded flap. Therefore, it can be concluded that the Caldwell-Luc technique benefits the closure of the bone defect, avoids fistulas and the area of ​​fibrosis in the membrane, being an effective and viable alternative for removing implants in the maxillary sinus region.

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