CASE STUDY: Closure of oro-antral-communication (OAC)
A 53 year old male patient presented with a sinus opening into the mouth. Drinking resulted in discharge of these fluids from the nose. He had no relevant medical history, no known allergies and wasn’t taking any medication. He had tooth 26 removed three days prior.
On examination an oro-antral-communication (OAC) was visible through the palatal socket of tooth 26. A CBCT was obtained to rule out any fractured root or foreign body in the left maxillary sinus.
The diagnosis made was OAC in the area of tooth 26, with the risk of left maxillary sinusitis forming if left untreated.
The agreed treatment was the primary closure of the OAC. A buccal advancement flap procedure was performed under local anaesthesia. This is where incisions are made into the buccal mucosa to create a flap, move coronally and cover the OAC. The flap is then sutured to the palatal mucosa to achieve complete closure of the OAC.
After the above treatment, a fistula developed and the OAC remained.
In a second procedure, the fistula was excised and the buccal advancement flap procedure was performed again.
This second procedure resulted in complete closure of the OAC and the patient was happy with the outcome of the treatment.