Cases reported "Oroantral Fistula"

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1/14. Treatment of a persistent oro-antral fistula with a posteriorly based lateral tongue flap.

    Occasionally an oro-antral communication persists after vigorous standard therapy. This case report demonstrates the successful use of a posteriorly based lateral tongue flap in such a situation.
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2/14. Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases.

    OBJECTIVE: This clinical report introduces a promising and unique method for the immediate closure of the oroantral communication (OAC) after tooth extraction: the use of the transplanted third molar with closed apices. STUDY DESIGN: In 2 adult patients, OAC caused by the extraction of an upper molar was immediately closed by using a transplanted third molar with complete root formation. After tooth extraction at the recipient site, OAC with perforated mucosa of the sinus floor was confirmed and the donor third molar was transferred to the prepared recipient socket. Endodontic therapy of the transplanted third molar began at 3 weeks after surgery, and prosthetic treatment was completed at 5 months after the operation. These 2 patients were carefully observed both clinically and radiographically. RESULTS: Closure of the OAC was successfully performed, and the transplanted teeth became fixed with the passage of time in these 2 patients. root resorption did not occur, and good functional results were obtained without any complications. CONCLUSIONS: Tooth transplantation of a mature third molar for closure of the OAC is a simple and excellent method because the transplanted tooth not only closes the communication to the maxillary sinus, but it also satisfactorily functions at the recipient site during mastication, even in adult patients.
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3/14. Non-surgical management of an oro-antral fistula in a patient with hiv infection.

    BACKGROUND: The risk of post-extraction complications is higher in patients who are immunosuppressed compared to other patients with normal immune function. In addition, invasive dental procedures are more likely to have serious complications in these patients. This case report demonstrates an effective non-surgical procedure to treat an oro-antral fistula in an hiv-infected man. methods: The oro-antral fistula was de-epithelialized under local anaesthesia and the patient wore a surgical splint continuously, removing it only for cleaning, for an eight week period. chlorhexidine gel was regularly applied to the fitting surface of the splint and the oro-antral communication. The patient was reviewed on a regular basis. RESULTS: This procedure resulted in resolution of the patient's symptoms within two weeks. Complete healing of the oro-antral fistula was evident following eight weeks of wearing the surgical splint. CONCLUSIONS: This procedure provided an effective method of treating an oro-antral fistula in an immunocompromised patient without causing any detrimental effects to the patient's overall health. Adequate pre-surgical assessment of patients prior to extractions is important in all patients to help prevent the occurrence of such complications.
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4/14. Dental implant therapy in the treatment of an oroantral communication after exodontia.

    A new technique in which a dental implant was the ultimate therapy for the treatment of an oroantral communication (OAC) that was created subsequent to the extraction of a maxillary first molar is described. A search of the English-speaking literature has not revealed implant therapy as part of documented modalities for the treatment of an OAC created following dental extraction. The OAC was closed by a sandwich technique that uses two resorbable membrane materials (Bio-Gide, Osteohealth, Shirley, NY) that surround a bone substitute (Bio-Oss, Osteohealth). This procedure, together with additional onlay grafting with the same bone substitute, was used also to regenerate subantral bone to enable the subsequent placement of an endosseous implant after 12 months. An 8-month postoperative radiograph showed creation of a new maxillary sinus bony floor and subantral bone of good quality, and height that can permit the placement of an endosseous dental implant.
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5/14. A new surgical management for oro-antral communication: the resorbable guided tissue regeneration membrane--bone substitute sandwich technique.

    This paper describes a new technique for the closure of oro-antral fistula/communication, in which both hard tissue (bone) and soft tissue closure is achieved. The sandwich technique utilizes a suitable bone grafting material sandwiched between two sheaths of Biogide (a resorbable membrane) for the hard tissue closure of oro-antral communication post traumatic exodontia. The bone grafting material utilized for this case was Bio-oss. The result obtained was excellent with regeneration of sufficient bony tissue to allow placement of an endosseous implant. This sandwich technique is a simple and excellent technique for the closure of oro-antral communication, especially when subsequent placement of endosseous implant is considered without the need of donor site surgery for bone grafting. The otorhinolaryngologists and oral and maxillofacial surgeons should find this technique very useful in the closure of oro-antral fistulae.
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6/14. maxillary sinusitis and periapical abscess following periodontal therapy: a case report using three-dimensional evaluation.

    BACKGROUND: maxillary sinusitis may develop from the extension of periodontal disease. In this case, reconstructed three-dimensional images from multidetector spiral computed tomographs were helpful in evaluating periodontal bony defects and their relationship with the maxillary sinus. methods: A 42-year-old woman in good general health presented with a chronic deep periodontal pocket on the palatal and interproximal aspects of tooth #14. Probing depths of the tooth ranged from 2 to 9 mm, and it exhibited a Class 1 mobility. Radiographs revealed a close relationship between the root apex and the maxillary sinus. The patient's periodontal diagnosis was localized severe chronic periodontitis. Treatment of the tooth consisted of cause-related therapy, surgical exploration, and bone grafting. A very deep circumferential bony defect at the palatal root of tooth #14 was noted during surgery. After the operation, the wound healed without incidence, but 10 days later, a maxillary sinusitis and periapical abscess developed. To control the infection, an evaluation of sinus and alveolus using computed tomographs was performed, systemic antibiotics were prescribed, and endodontic treatment was initiated. RESULTS: Two weeks after surgical treatment, the infection was relieved with the help of antibiotics and endodontic treatment. Bilateral bony communications between the maxillary sinus and periodontal bony defect of maxillary first molars were shown on three-dimensional computed tomographs. The digitally reconstructed images added valuable information for evaluating the periodontal defects. CONCLUSION: Three-dimensional images from spiral computed tomographs (CT) aided in evaluating and treating the close relationship between maxillary sinus disease and adjacent periodontal defects.
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7/14. Pedicle tongue flap for closure of an oroantral defect after partial maxillectomy.

    The position, size, and composition of the tongue make it ideal as a potential donor site for repair of certain oral defects. Adherence to principles of sound flap design must be followed. A technique for closure of large oroantral communications with use of a pedicled graft from the lateral border of the tongue has been described. This procedure provides the patient with immediate repair of the defect, while maintaining the relatively normal anatomic architecture of the oral cavity. We believe that this technique is also applicable to closure of other types of oroantral defects in addition to those described.
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8/14. Post-traumatic prandial rhinorrhea.

    A patient with a LeFort III fracture developed clear prandial rhinorrhea as a late complication. A parotid-antral communication was discovered and surgically corrected. Only one previous case of parotid-antral rhinorrhea has been reported in the literature. Although it is a rare complication, salivary origin for post-traumatic rhinorrhea must be considered in the differential diagnosis.
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9/14. Treatment of oro-antral-nasal fistula after anterior maxillary osteotomy.

    A case of a patient with an open bite deformity was presented that, because of improper preoperative treatment planning, resulted in an oro-antral-nasal communication. The subsequent re-evaluation of the patient and the corrective surgical procedure are discussed, with a retrospective evaluation of the total treatment sequence.
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10/14. Immediate repair of the oroantral communication: a preventive dental procedure.

    A two-layer sliding flap technique to repair an oroantral communication has been described. This procedure can be performed quickly and without special instrumentation. No additional regional anesthesia is necessary. It does not require reduction of the buccal plate and therefore preserves the integrity of the alveolus. Most importantly, this technique can reduce the incidence of oroantral fistula and subsequent secondary reparative operations.
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