Max sinus in surgery

Question 1

Invasion of the maxillary sinus and establishment of a direct communication with the
oral cavity is referred to as an _______

Answer 1

“oro -antral communication”

Question 2

What type of movement is used to remove max roots with root tip elevator?

Answer 2

Wiggling motion

Question 3

To confirm the presence of a communication, the best technique is to use the ________

Answer 3

“Nose-blowing
test” (Valsalva Maneuver).

Question 4

HOw do you confirm diagnosis of OAC with or without root tips?

Answer 4

Radiographs

Question 5

What size of OAC requires no further surgical treatment other than sinus precautions?

Answer 5

Small 2mm or less

Question 6

What size of OAC requires the following:
* Ensure the maintenance of the blood clot in the area, a figure-of-eight suture should be placed
over the tooth socket .

• Antibiotics, usually Augmentin, should be prescribed for 7 days.
• A nasal decongestant spray should be prescribed to shrink the nasal mucosa to keep the ostium of
  the sinus patent.

Answer 6

Moderate size OAC 2-6mm

Question 7

What size OAC requires the following:
* Dentist should consider closing the sinus communication with a flap procedure.

• Usually requires that the patient be referred to an oral and maxillofacial surgeon.
• Flap development and closure of a sinus opening are somewhat complex procedures that require
  skill and experience.
  – most commonly used flap is a buccal flap
• This technique mobilizes buccal soft tissue to cover the opening and provide for a
  primary closure

Answer 7

Large 7mm or more

Question 8

What is the disadvantage to the buccal advancement flap?

Answer 8

Loss of vestibular depth

Question 9

What type of flap procedure is most commonly used for flap surgeries to cover large OAC?

Answer 9

Buccal advancement flap

Question 10

What is the key to the buccal advancement flap?

Answer 10

Periosteal incision/release so that the flap is mobilized enough to cover OAC

Question 11

For OAC flap procedures, should the flap be placed under tension?

Answer 11

Never; tension-free wound margins

Question 12

What is an OAC with an epithelial lining?

Answer 12

Oro-antral fistula

Question 13

If the O.A.C is left untreated, The two sequelae of most concern are:

Answer 13

• Formation of a chronic oroantral fistula.
• Postoperative maxillary sinusitis

Question 14

• Is a biological tract that connects an anatomical cavity with the external
  surfaces or another anatomical cavity (unlike sinus tract).
• It is always lined with a stratified squamous epithelium and the patency of
  the tract is preserved until epithelial cells scraped off.

Answer 14

Fistula