Comunicação bucossinusal após exodontia : relato de dois casos

Abstract

Oroantral communication (OAC) is a pathological communication that occurs between the oral cavity and the maxillary sinus, called oroantral fistula resulted by epithelization of communication, which occurs in up to 48 hours. These complications occur most commonly during extraction of upper molar and premolar teeth. The major reason is the anatomic proximity or projection of the roots within the maxillary sinus. This case report demonstrates information about the predisposing factors and diagnostic methods, as well as the surgical treatments used to close the OAC, as well as reporting two cases of OAC after dental extraction. In both cases, two patients sought the Service of Surgery in Buccomaxillofacial Surgery and Traumatology of the University of the State of Amazonas feeling pain in the right maxilla and reported to feel the flow of liquids between the oral and the nasal cavities when ingesting them. The anamnesis, the clinical examination, the Valsalva maneuver and the Computed Tomography (CT) were done to diagnose OAC. The first report is of patient EMM, female, 43 years old, presenting oroantral fistula in the area of element 16 and radicular fragment into maxillary sinus observed in CT and removed through the Caldwell-luc access and vestibular flap. The second case was a patient ORVF, male, 53 years old, presenting oroantral fistula in area of element 16 treated with vestibular flap surgical intervention. The techniques used in the present cases were effective and easy to perform, providing a comfortable postoperative period for the patients and no recurrence of the reports. Patients progressed satisfactorily, with regression of all initial symptoms. It was concluded that anamnesis and well-conducted clinical examination plus a quality image exam were fundamental tools for the diagnosis, treatment and resolution of the presented cases.