Dental Extraction Complications

Oroantral Fistula Diagnosis and Management

• An oroantral fistula is a communication between the maxillary sinus and the oral cavity.

Causes of Oroantral Fistula

• The most common cause of oroantral fistula is upper molar extractions, with approximately 1-2% of extractions creating oroantral communications.
• The predisposing factor for the formation of oroantral fistulae after tooth extraction is the close proximity of the maxillary sinus to the roots of the upper molar teeth.

Signs and Symptoms of Oroantral Fistula

• Nasal discharge and blocked nose are possible symptoms of an oroantral fistula.
• The most likely reason for the patient's nasal discharge and blocked nose is the presence of an oroantral fistula.

Diagnosis of Oroantral Fistula

• The definitive test for confirming oroantral fistula if there is no history of fluid or air passing between the sinus and mouth is the use of a water test or methylene blue test.
• Radiographs of the antrum can be used to investigate oroantral fistula, with the aim of determining the presence of any abnormalities in the sinus.
• A CT scan is used to exclude the possibility of other lesions such as malignant neoplasms in cases of suspected oroantral fistula.

Consequences of Unmanaged Oroantral Fistula

• Possible consequences of an unmanaged oroantral fistula include chronic infection, sinusitis, and nasal discharge.

Treatment Approach

• A possible treatment approach for the patient's condition would involve surgical closure of the oroantral fistula.

Differential Diagnosis

• Dry socket is less likely in this case due to the presence of nasal discharge and blocked nose, which are not typical symptoms of dry socket.