Surgical Techniques for Closure of Oro-Antral Communications

Content
With a maxillary sinus recess reaching far into the alveolar process of the maxilla, the maxillary sinus can sometimes be opened when maxillary incisors are extracted. An oro-antral communication is determined by a nose-blowing test or by sounding out of the alveolus with blunt probes. After an inflamed, cystic, or tumorous maxillary sinus illness has been excluded, an oro-antral communication should be closed immediately with plastic surgery within the first 24 hours after extraction to prevent the germ-free maxillary sinus from being contaminated. Plastic covering by plastic surgery using a cheek flap with vestibular stem is demonstrated. After a mucoperiosteal flap with vestibular stem has been formed, the flap is lengthened by slitting the periosteum so that a tension-free sealing of the opened maxillary sinus will be possible without endangering the flap's blood flow at the same time.

Outline

• Diagnostics of an oro-antral communication
• Exclusion of inflammatory, cystic, or tumorous maxillary sinus illnesses
• Cheek flap plastic surgery for plastic covering of an oro-antral communication
• Cutting direction for the formation of a mucoperiosteal flap with vestibular stem
• De-epithelalization of wound margins
• Mobilization of the flap by slitting the periosteum
• Periosteal holding stitches for tension-free closure of the oro-antral communication
• Stitching technique for saliva-proof wound closure
• Demonstration of buccal flap plastic surgery
• Demonstration of bridge flap plastic surgery
• Demonstration of palatal flap plastic surgery
• Postoperative reaction measures