Comprehensive Review of Oroantral Communication Management: Techniques and Outcomes

Abstract

Oroantral communications (OACs) and oroantral fistulas (OAFs) are common complications encountered in oral and maxillofacial surgery, often resulting from dental extractions, implant procedures, or pathological conditions. Timely and effective management is crucial to prevent further complications such as maxillary sinusitis. This comprehensive review explores various techniques for OAC and OAF closure, discussing their indications, advantages, and limitations. Traditional soft tissue approaches, including buccal advancement flaps, palatal flaps, and buccal fat pad grafts, demonstrate high success rates but may be limited by defect size and anatomical considerations. Advanced techniques such as the use of platelet-rich fibrin, resorbable collagen membranes, and bone grafts offer promising outcomes for complex cases, promoting both soft and hard tissue healing. Alternative methods like tongue flaps, metal foils, hydroxyapatite blocks, and third molar transplantation expand the treatment options for challenging scenarios. Additionally, this review addresses the management of OACs in immunocompromised patients and highlights the potential of low-level laser therapy in enhancing wound healing. The choice of treatment should be individualized based on factors such as defect size, patient health status, and available resources. A multidisciplinary approach and the adoption of innovative materials and techniques can significantly improve patient outcomes and reduce the morbidity associated with OAC and OAF management.