von Arx Thomas, von Arx Joya, Bornstein Michael M
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Private Practice Dr. R. Wymann, Bern, Switzerland.
Swiss Dent J. 2020 Dec 7;130(12):972-982. doi: 10.61872/sdj-2020-12-702.
The objective of this study was to analyze the outcome of first-time surgical closures of oroantral communications (OAC) after tooth extractions. Using a billing software, all patients treated in a surgery department were filtered for interventions of the maxillary sinus indicative of OAC therapy. Out of 221 initially eligible cases, the charts of 162 cases fulfilling the inclusion criteria were retrospectively evaluated for the outcome in terms of symptom-free OAC closure as well as possibly influencing patient and treatment factors. The analyzed cohort included 98 males (60.5%) and 64 females (39.5%) with a mean age of 48.6 years (range 17 to 86 years). The maxillary 1st molar (38.3%) was the most common site requiring OAC closure. In 60.5% of the cases, surgical OAC closure was performed immediately after tooth extraction. The Rehrmann flap (72.2%) was the most frequently used technique for surgical OAC closure. 94.4% of surgical OAC closures were successful. Gender and age did not influence the outcome. In contrast, the site of OAC and the time interval from tooth extraction to OAC closure affected the results. Furthermore, the Rehrmann flap, alone or in combination with biomaterials, was superior to the mere suturing (with or without biomaterials) of the OAC site. In conclusion, the Rehrmann flap alone or in combination with biomaterials provided high success rates for first-time surgical OAC closure. With regard to the study parameters, an OAC in the 3rd molar area and an extended interval from tooth extraction to OAC closure negatively influenced the resolution of OAC. However, results must be interpreted cautiously considering the retrospective study design and the limited number of cases.
本研究的目的是分析拔牙后首次手术封闭口腔上颌窦瘘（OAC）的结果。使用计费软件，对手术科室治疗的所有患者进行筛选，以确定上颌窦干预措施是否表明为OAC治疗。在最初符合条件的221例病例中，对162例符合纳入标准的病例进行回顾性评估，以确定无症状OAC封闭的结果以及可能影响患者和治疗的因素。分析的队列包括98名男性（60.5%）和64名女性（39.5%），平均年龄为48.6岁（范围17至86岁）。上颌第一磨牙（38.3%）是最常见的需要封闭OAC的部位。在60.5%的病例中，拔牙后立即进行手术封闭OAC。Rehrmann瓣（72.2%）是手术封闭OAC最常用的技术。94.4%的手术封闭OAC成功。性别和年龄不影响结果。相比之下，OAC的部位以及从拔牙到OAC封闭的时间间隔影响结果。此外，Rehrmann瓣单独或与生物材料联合使用优于单纯缝合（有或无生物材料）OAC部位。总之，单独使用Rehrmann瓣或与生物材料联合使用在首次手术封闭OAC方面成功率很高。就研究参数而言，第三磨牙区域的OAC以及从拔牙到OAC封闭的延长时间间隔对OAC的愈合有负面影响。然而，考虑到回顾性研究设计和病例数量有限，结果必须谨慎解释。
