OROANTRAL COMMUNICATION FOLLOWING MAXILLARY TOOTH EXTRACTION: DIAGNOSIS, PREVENTION, AND CONTEMPORARY MANAGEMENT – A NARRATIVE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6582Keywords:
Oroantral Communication, Oroantral Fistula, Maxillary Sinus, Tooth Extraction, Cone-beam Computed Tomography, Surgical Management, Buccal Fat Pad, Platelet-rich FibrinAbstract
Oroantral communication (OAC) is one of the most common complications associated with the extraction of maxillary posterior teeth and may lead to chronic oroantral fistula (OAF) formation and odontogenic maxillary sinusitis if not diagnosed and treated promptly. Early recognition and appropriate management are essential to prevent persistent communication, sinus infection, and long-term morbidity. This narrative review aims to summarize current concepts in the diagnosis and management of OAC, with particular emphasis on evidence-based clinical decision-making and recent advances in surgical treatment. The review discusses the etiology and risk factors associated with OAC, contemporary diagnostic methods, including the role of cone-beam computed tomography (CBCT), and strategies for preventing this complication during maxillary tooth extraction. Furthermore, current management options are presented, ranging from conservative treatment of small communications to various surgical techniques, including buccal advancement flaps, palatal flaps, pedicled buccal fat pad, and regenerative approaches using platelet-rich fibrin (PRF). The importance of controlling maxillary sinus infection, selecting an appropriate surgical technique based on defect characteristics, and providing adequate postoperative care is also highlighted. Recent evidence supports an individualized treatment approach that considers the size and duration of the defect, the presence of sinus pathology, and patient-specific factors. Advances in regenerative techniques and minimally invasive procedures have expanded the therapeutic options available to clinicians and have contributed to improved clinical outcomes. A comprehensive understanding of current diagnostic and therapeutic principles is essential for achieving predictable closure of OAC and minimizing postoperative complications.
References
Dipalma, G., Inchingolo, A. M., Trilli, I., Ferrante, L., Di Noia, A., de Ruvo, E., et al. (2025). Management of oro-antral communication: A systemic review of diagnostic and therapeutic strategies. Diagnostics (Basel), 15(2), 194. https://doi.org/10.3390/diagnostics15020194
Oliva, S., Lorusso, F., Scarano, A., D’Amario, M., & Murmura, G. (2024). The treatment and management of oroantral communications and fistulas: A systematic review and network metanalysis. Dent J (Basel), 12(5), 147. https://doi.org/10.3390/dj12050147
Shahrour, R., Shah, P., Withana, T., Jung, J., & Syed, A. Z. (2021). Oroantral communication, its causes, complications, treatments and radiographic features: A pictorial review. Imaging Sci Dent, 51(3), 307–311. https://doi.org/10.5624/isd.20210035
Kwon, M. S., Lee, B. S., Choi, B. J., Lee, J. W., Ohe, J. Y., Jung, J. H., et al. (2020). Closure of oroantral fistula: A review of local flap techniques. J Korean Assoc Oral Maxillofac Surg, 46(1), 58–65. https://doi.org/10.5125/jkaoms.2020.46.1.58
Khandelwal, P., & Hajira, N. (2017). Management of oro-antral communication and fistula: Various surgical options. World J Plast Surg, 6(1), 3–8.
Borgonovo, A. E., Berardinelli, F. V., Favale, M., & Maiorana, C. (2012). Surgical options in oroantral fistula treatment. Open Dent J, 6, 94–98. https://doi.org/10.2174/1874210601206010094
Bhalla, N., Sun, F., & Dym, H. (2021). Management of oroantral communications. Oral Maxillofac Surg Clin North Am, 33(2), 249–262. https://doi.org/10.1016/j.coms.2021.01.002
Jurásek, A., Farkas, N., Frank, D., Kolarovszki, B., Sándor, B., Radácsi, A., et al. (2024). Evaluation of clinical and radiographic warning signs for prediction of oroantral communication following tooth extractions. Clin Oral Investig, 28(11), 609. https://doi.org/10.1007/s00784-024-06000-x
De Biasi, M., Maglione, M., & Angerame, D. (2014). The effectiveness of surgical management of oroantral communications: A systematic review of the literature. Eur J Oral Implantol, 7(4), 347–357.
Galli, M., De Soccio, G., Cialente, F., Candelori, F., Federici, F. R., Ralli, M., et al. (2020). Chronic maxillary sinusitis of dental origin and oroantral fistula: The results of combined surgical approach in an italian university hospital. Bosn J Basic Med Sci, 20(4), 524–530. https://doi.org/10.17305/bjbms.2020.4748
Andrić, M., Saranović, V., Dražić, R., Brković, B., & Todorović, L. (2010). Functional endoscopic sinus surgery as an adjunctive treatment for closure of oroantral fistulae: A retrospective analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 109(4), 510–516. https://doi.org/10.1016/j.tripleo.2009.10.028
Demetoglu, U., Ocak, H., & Bilge, S. (2018). Closure of oroantral communication with plasma-rich fibrin membrane. J Craniofac Surg, 29(4), e367-e370. https://doi.org/10.1097/SCS.0000000000004360
Peñarrocha-Oltra, D., Alonso-González, R., Pellicer-Chover, H., Aloy-Prósper, A., & Peñarrocha-Diago, M. (2015). Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up. J Clin Exp Dent, 7(1), e159-e162. https://doi.org/10.4317/jced.51741
Alonso-González, R., Peñarrocha-Diago, M. A., Peñarrocha-Oltra, D., Aloy-Prósper, A., Camacho-Alonso, F., & Peñarrocha-Diago, M. (2015). Closure of oroantral communications with bichat’s buccal fat pad: Level of patient satisfaction. J Clin Exp Dent, 7(1), e28-e33. https://doi.org/10.4317/jced.51730
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Zofia Wiśniewska, Ewa Jurkowska
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
