Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

A student guide to oro-antral communication

BDJ Student volume 30, pages 22–24 (2023)Cite this article

Oro-antral communications and fistulas (OACs & OAFs) are common complications confronting dentists and oral and maxillofacial surgeons. An OAC is an unnatural communication (hole) between the oral cavity and the maxillary sinus.1 Predominantly these complications occur during extraction of upper molar and premolar teeth (48%).2 This happens due to the anatomic proximity of the roots to the maxillary sinus. Other causes of OACs include tuberosity fracture, dentoalveolar/periapical infections, iatrogenic damage (e.g. root or implant dislodged into maxillary sinus or inappropriate elevation), trauma, presence of maxillary cysts or tumours and osteoradionecrosis.3 OACs can be further categorised as alveolo-sinusal, palatal-sinusal, and vestibulo-sinusal based on their location.

An OAF is an epithelialised pathological unnatural communication between the oral cavity and maxillary sinus.4 It develops when the OAC remains patent and gets epithelialised. This process usually begins within the first 48-72 hours alongside osteitis of the surrounding bony margins, presence of foreign bodies or development of maxillary sinusitis. These developments hamper spontaneous healing leading to chronic fistula formation. On average, it takes 7-8 days for an OAC to become a chronic fistulous tract.2

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Bhalla N, Sun F, Dym H. Management of Oroantral Communications. Oral Maxillofac Surg Clin N Am 2021; 33: 249-262.

  2. Khandelwal P, Hajira N. Management of Oro-antral Communication and Fistula: Various Surgical Options. World J Plast Surg 2017; 6: 3-8.

  3. Dym H, Wolf J. Oroantral Communication. Oral Maxillofac Surg Clin N Am 2012; 24: 239-247.

  4. Parvini P, Obreja K, Begic A, et al. Decision-making in closure of oroantral communication and fistula. Int J Implant Dent 2019; 5: 13.

  5. Shahrour R, Shah P, Withana T, Jung J, Syed A. Oroantral communication, its causes, complications, treatments and radiographic features: A pictorial review. Imaging Sci Dent 2021; 51: 307.

  6. Lewusz-Butkiewicz K, Kaczor K, Nowicka A. Risk factors in oroantral communication while extracting the upper third molar: Systematic review. Dent Med Problems 2018; 55: 69-74.

  7. British Association of Oral Surgeons. Information for patients: Oro-antral Communication (OAC). 2022. Available online at: www.baos.org.uk/wp-content/uploads/2019/03/Oral-antral-Communications-final.pdf (accessed November 2022).

  8. BNF. Ephedrine hydrochloride | Drugs | BNF content published by NICE. 2022. Available online at: https://bnf.nice.org.uk/drugs/ephedrine-hydrochloride/#cautions (accessed November 2022).

  9. Logan R, Coates E. Non-surgical management of an oro-antral fistula in a patient with HIV infection. Aust Dent J 2003; 48: 255-258.

  10. Belmehdi A, El Harti K. Management of oroantral communication using buccal advanced flap. Pan Afr Med J 2019; 34: 69.

  11. Kim M, Han W, Kim S. The use of the buccal fat pad flap for oral reconstruction. Maxillofac Plast Reconstr Surg 2017; 39: 5.

Download references

Author information

Authors and Affiliations

  1. Oral and Maxillofacial Surgery Department, Manchester Royal Infirmary, Manchester, United Kingdom

    Owen Harries

  2. Bupa Dental Care, Sale, Manchester, United Kingdom

    Jessica Hutton

Authors
  1. Owen Harries
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jessica Hutton
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Owen Harries.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Harries, O., Hutton, J. A student guide to oro-antral communication. BDJ Student 30, 22–24 (2023). https://doi.org/10.1038/s41406-022-0920-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41406-022-0920-8

Search

Advanced search

Quick links