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Oral and Maxillofacial Surgery
Published in: Oral and Maxillofacial Surgery 4/2016

01-12-2016 | Original Article

Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth

Authors: Takumi Hasegawa, Akira Tachibana, Daisuke Takeda, Eiji Iwata, Satomi Arimoto, Akiko Sakakibara, Masaya Akashi, Takahide Komori

Published in: Oral and Maxillofacial Surgery | Issue 4/2016

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Abstract

Purpose

The relationship between radiographic findings and the occurrence of oroantral perforation is controversial. Few studies have quantitatively analyzed the risk factors contributing to oroantral perforation, and no study has reported multivariate analysis of the relationship(s) between these various factors. This retrospective study aims to fill this void.

Methods

Various risk factors for oroantral perforation during maxillary third molar extraction were investigated by univariate and multivariate analysis. The proximity of the roots to the maxillary sinus floor (root-sinus [RS] classification) was assessed using panoramic radiography and classified as types 1–5. The relationship between the maxillary second and third molars was classified according to a modified version of the Archer classification. The relative depth of the maxillary third molar in the bone was classified as class A–C, and its angulation relative to the long axis of the second molar was also recorded.

Results

Performance of an incision (OR 5.16), mesioangular tooth angulation (OR 6.05), and type 3 RS classification (i.e., significant superimposition of the roots of all posterior maxillary teeth with the sinus floor; OR 10.18) were all identified as risk factors with significant association to an outcome of oroantral perforation.

Conclusion

To our knowledge, this is the first multivariate analysis of the risk factors for oroantral perforation during surgical extraction of the maxillary third molar. This RS classification may offer a new predictive parameter for estimating the risk of oroantral perforation.
Literature
1.
Worrall SF, Riden K, Haskell R, Corrigan AM (1998) UK National Third Molar project: the initial report. Br J Oral Maxillofac Surg 36(1):14–18CrossRefPubMed
2.
Rothamel D, Wahl G, d'Hoedt B, Nentwig GH, Schwarz F, Becker J (2007) Incidence and predictive factors for perforation of the maxillary antrum in operations to remove upper wisdom teeth: prospective multicentre study. Br J Oral Maxillofac Surg 45(5):387–391CrossRefPubMed
3.
Berge TI (1996) Complications requiring hospitalization after third-molar surgery. Acta Odontol Scand 54(1):24–28CrossRefPubMed
4.
Berge TI (1996) Incidence of infections requiring hospitalization associated with partially erupted third molars. Acta Odontol Scand 54(5):309–313CrossRefPubMed
5.
Bui CH, Seldin EB, Dodson TB (2003) Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg 61(12):1379–1389CrossRefPubMed
6.
Al-Khateeb TL, El-Marsafi AI, Butler NP (1991) The relationship between the indications for the surgical removal of impacted third molars and the incidence of alveolar osteitis. J Oral Maxillofac Surg 49(2):141–146CrossRefPubMed
7.
Chiapasco M, De Cicco L, Marrone G (1993) Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol. 76(4):412–420CrossRefPubMed
8.
Chiapasco M, Crescentini M, Romanoni G (1995) Germectomy or delayed removal of mandibular impacted third molars: the relationship between age and incidence of complications. J Oral Maxillofac Surg 53(4):418–423CrossRefPubMed
9.
Lim AA, Wong CW, Allen JC Jr (2012) Maxillary third molar: patterns of impaction and their relation to oroantral perforation. J Oral Maxillofac Surg 70(5):1035–1039CrossRefPubMed
10.
Archer HW (1975) Oral and maxillofacial surgery (ed 5). WB Saunders, Philadelphia, PA, p. 311
11.
Nedbalski TR, Laskin DM (2008) Use of panoramic radiography to predict possible maxillary sinus membrane perforation during dental extraction. Quintessence Int 39(8):661–664PubMed
12.
Handa K, Nagase M, Nakajima T, Yamagami S (1988) Clinical study on 16 teeth displased into the maxillary sinus. Jpn. J Oral Maxillofac Surg 34(6):53–59 in Japanese
13.
von Wowern N (1970) Frequency of oro-antral fistulae after perforation to the maxillary sinus. Scand J Dent Res 78(5):394–396
14.
Ehrl PA (1980) Oroantral communication. Epicritical study of 175 patients, with special concern to secondary operative closure. Int J Oral Surg 9(5):351–358CrossRefPubMed
15.
Punwutikorn J, Waikakul A, Pairuchvej V (1994) Clinically significant oroantral communications—a study of incidence and site. Int J Oral Maxillofac Surg 23(1):19–21CrossRefPubMed
16.
Killey HC, Kay LW (1967) An analysis of 250 cases of oro-antral fistula treated by the buccal flap operation. Oral Surg Oral Med Oral Pathol 24(6):726–739CrossRefPubMed
17.
Bodner L, Gatot A, Bar-Ziv J (1995) Technical note: oroantral fistula: improved imaging with a dental computed tomography software program. Br J Radiol 68(815):1249–1250CrossRefPubMed
18.
Kim E, Fallahrastegar A, Hur YY, Jung IY, Kim S, Lee SJ (2005) Difference in root canal length between Asians and Caucasians. Int Endod J 38(3):149–151CrossRefPubMed
19.
Visscher SH, van Roon MR, Sluiter WJ, van Minnen B, Bos RR (2011) Retrospective study on the treatment outcome of surgical closure of oroantral communications. J Oral Maxillofac Surg 69(12):2956–2961CrossRefPubMed
20.
Poeschl PW, Baumann A, Russmueller G, Poeschl E, Klug C, Ewers R (2009) Closure of oroantral communications with Bichat's buccal fat pad. J Oral Maxillofac Surg 67(7):1460–1466CrossRefPubMed
21.
Abuabara A, Cortez AL, Passeri LA, de Moraes M, Moreira RW (2006) Evaluation of different treatments for oroantral/oronasal communications: experience of 112 cases. Int J Oral Maxillofac Surg 35(2):155–158CrossRefPubMed
Metadata
Title
Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth
Authors
Takumi Hasegawa
Akira Tachibana
Daisuke Takeda
Eiji Iwata
Satomi Arimoto
Akiko Sakakibara
Masaya Akashi
Takahide Komori
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 4/2016
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-016-0574-1

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