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Oroantral fistula

Case contributed by Mostafa Elfeky
Diagnosis certain

Presentation

Discharge and sourness in mouth following posterior maxillary tooth extraction.

Patient Data

Age: 35 years
Gender: Female

CT paranasal sinuses

ct

A bony defect is noted involving the most posterior aspect of the right side of the maxillary alveolar process violating the most posterior aspect of the floor of the right maxillary antrum. It is about 12 mm in size representing right sided oroantral fistula.

This defect is partially closed with roots of malaligned tooth showing roots directed medially and in cephalic direction losing its crown and migrating into the maxillary sinus, likely supernumerary tooth with missing of the third maxillary molar correlated with history of recent tooth extraction and supported by the presence of similar supernumerary tooth on the left side posterior to the third maxillary molar showing buccally oriented crown.

The right maxillary antrum is consequently showing thickened mucosa with compromised outflow tracts (Right maxillary sinusitis).

Small mucous retention cyst involving the alveolar recess of the left maxillary antrum is noted.

Case Discussion

Oroantral fistula (OAF) is most commonly occurs as a complication following extraction of the upper dentition. It is a communication between the maxillary sinus floor and the oral cavity through a bony defect of the alveolar process of maxilla.

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