MaxSinus lecture 2

MaxSinus lecture 2 - Maxillary sinus in Dentoalveolar...

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Maxillary sinus in Dentoalveolar Surgery and Trauma
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Oro-antral fistula: Invasion of the maxillary sinus and establishment of a direct communication with the oral cavity is referred to as an oro-antral fistula.
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Fistula: Is a biological tract that connect 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 potency of the tract is preserved until epithelial cells scraped off.
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Factors influencing creation of oro-antral fistula: Teeth size and configuration of the roots. Hypercementosis and bulbous roots. Density of alveolar bone and thickness of sinus floor Size of the sinus. Relation of sinus to the root of upper teeth. Rough extraction and misguided manipulation. Apical pathosis and attached granulomas. Periodontal diseases which may erode sinus floor. Presence of cysts and neoplasm. Invasive surgery e.g. cleft and dental implants placement.
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Signs and symptoms of newly created oro-antral fistula: Antral floor attached to roots apices of extracted tooth or teeth. Fracture of the alveolar process or the tuberosity. Evidence of air stream passing from nostril. Bubbling of blood from the socket or nostril. Change in speech tone and resonance. Radiographical evidence of sinus involvement.
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Confirmation of existence of oro-antral fistula Instruct patient to occlude the nostrils and blow genteelly “nose-blowing’ test”. If nose-blowing’ test is negative, don’t explore the opening with suction tip and/or probes. Don’t attempt to irrigate the sinus to confirm diagnosis, especially if the sinus drainage is impaired due to pre- existed sinusitis. Always check radiograph for the continuity of sinus floor and presence of entrapped foreign body.
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Displacement of tooth or root into the maxillary sinus lining or the sinus cavity proper It is basically a mishap incident results from a neglected act by the operator while applying wrong force. Occurs rarely but the 3
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MaxSinus lecture 2 - Maxillary sinus in Dentoalveolar...

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