Oroantral communication, its causes, complications, treatments and radiographic features: A pictorial review

Abstract

Purpose: An oroantral communication (OAC) is an abnormal space between the maxillary sinus and oral cavity. The causes, complications, treatment, and radiographic features of OAC in 2-dimensional and 3-dimensional imaging modalities are discussed.

Materials and methods: This pictorial review presents a broad spectrum of imaging findings of OAC. Representative radiographs depicting OAC were chosen from our database. PubMed was used to conduct a comprehensive literature search of OAC.

Results: Characteristic features of OAC include discontinuity of the maxillary sinus floor, thickening of the maxillary sinus mucosa, or a combination of both. Two-dimensional imaging modalities are the method of choice for identifying discontinuities in the maxillary sinus floor. However, 3-dimensional imaging modalities are also essential for determining the status of soft tissue in the maxillary sinus.

Conclusion: The integration of 2-dimensional and 3-dimensional imaging modalities is crucial for the correct diagnosis and comprehensive treatment of OAC. However, the diagnosis of OAC must be confirmed clinically to prevent unnecessary mental and financial burdens to patients.

Keywords: Cone-Beam Computed Tomography; Diagnostic imaging; Maxillary Sinus; Oroantral Fistula; Tooth Extraction.

Conflict of interest statement

Conflicts of Interest: None

Copyright © 2021 by Korean Academy of Oral and Maxillofacial Radiology.

Figures

Fig. 1. An illustration shows an oroantral communication through the palatal root of the left maxillary first molar (white arrow).

Fig. 2. Panoramic radiograph of a 73-year-old woman. An oroantral communication can be noted in the upper right quadrant in the right maxillary first molar extraction site (white arrow). Note the discontinuity of the maxillary sinus floor.

Fig. 3. Periapical radiograph of a 73-year-old man. Note the loss of cortical plate in the extraction site of the right maxillary first molar (white arrow).

Fig. 4. Multiplanar reformatted conebeam computed tomographic images of a 63-year-old woman. A. An axial image shows loss of the buccal cortical plate in the right maxillary first molar extraction site (white arrow) and loss of both buccal and lingual cortical plates in the left maxillary first molar extraction site (white arrows). B. A sagittal image shows loss of cortication in the left maxillary sinus (white arrow). C. A coronal image shows the extraction sockets (white arrow). On the right side, note the loss of both the buccal cortical plate and floor of the maxillary sinus and the presence of mild mucosal thickening (white arrow) at the floor of the sinus. On the left side, note the loss of buccal and lingual cortical plates and circumferential soft tissue thickening of the maxillary sinus (white arrow). Calcified material (antrolith) can be noted in the left maxillary sinus. D. A volume-rendered image shows the loss of the cortical plate at the left maxillary first molar's extraction site (white arrow).

Fig. 5. A. An axial image shows a breach in the posterior wall of the left maxillary sinus and polypoidal mucosal thickening in the right maxillary sinus (white arrow). B. A coronal image shows polypoidal mucosal thickening in the right maxillary sinus (white arrow).

Fig. 6. Volumetric scan superimposed on a volume-rendered scan of a 56-year-old man. Note the breach of the posterior wall of the left maxillary sinus and the consequent narrowing of the sinus (white arrow).