Treatment of oroantral communication as a complication of posterious-superior teeth extraction. Literature review

Abstract

Introduction: Oroantral communication (OAC) is a frequent complication after posterosuperior tooth extraction, associated with the proximity between the dental roots and the maxillary sinus. Its therapeutic management depends on the size of the defect, the presence of infection and the conditions of the patient. Objective: To analyze and critically organize the available evidence published in the last five years on the therapeutic options for the treatment of COA, secondary to extraction, to propose an indicative clinical protocol. Methodology: A narrative review was conducted by electronic search in PubMed, SciELO, Cochrane Library, ProQuest Research Library and Google Scholar. MeSH terms and keywords combined with Boolean operators were used. Studies published between January 2019 and July 2024 in English, Spanish, French, and Portuguese were included. Defined inclusion and exclusion criteria were applied. Results: Thirty articles were included in this review, addressing different therapeutic approaches for the management of oroantral communication (OAC). The evidence reviewed shows that defects <3 mm without infection can heal spontaneously. Defects 3-5 mm benefit from primary suturing. Defects larger than 5 mm require surgical approaches, including mucosal flaps, Bichat flaps, PRF and combined techniques in complex cases. A lack of consensus was identified regarding the choice of treatment according to defect size. Conclusions: Treatment of COA should be personalized according to the clinical context. A preliminary clinical protocol is proposed as a tool to guide decision making, emphasizing the need for future comparative research and the creation of standardized clinical guidelines. General Area of Study: Health. Specific area of study: Oral surgery. Type of study: Literature review.