106例拔牙导致口腔上颌窦交通的临床分析

A clinical analysis of 106 cases of oroantral communications caused by tooth extraction

目的分析拔牙导致口腔上颌窦交通(oroantral communications, OAC)的临床特点、处理方法、预后情况及预防措施。方法收集106例自2017年1月至2020年6月间在第四军医大学口腔医院口腔外科处理OAC患者的病历资料,并进行回顾性分析。结果 OAC好发于10~30岁,男女发生比例1∶1.25。最常见的发病部位为上颌第三磨牙;造成OAC的主要原因是上颌阻生牙的拔除。所有OAC患者采用牙槽窝内放置胶原塞封闭交通口的方法进行处理,均未发生上颌窦瘘。结论 OAC可发生于各年龄段。各解剖因素,牙根周围的骨质破坏,以及术者缺乏操作经验是导致OAC发生的主要因素。术前充分考虑这些因素可预防OAC的发生。使用胶原塞保守治疗OAC可有效预防上颌窦瘘的发生。

Objective To analyze the clinical characteristics, treatment,prognosis and prevention of oroantral communications(OAC) caused by tooth extraction. Methods From January 2017 to June 2020, 106 cases with OAC treated in the Stomatological Hospital of the Fourth Military Medical University were collected and analyzed retrospectively. Results The majority of OAC were found in 10 to 30 years old patients, and the ratio of male to female was 1∶1.25. The predilection site of OAC was the maxillary third molars. The main cause of OAC was the extraction of maxillary impacted tooth. All patients were treated by placing a collagen plug in the alveolar to close the communications, and no oroantral fistula occurred. Conclusion OAC can occur in all age groups and is more common in young people. Anatomical factors, periradicular bone destruction, and operator’s experience are three main risk factors for OAC. These factors should be fully considered before operation to prevent OAC. Conservative treatment of OAC with collagen plug can effectively prevent oroantral fistula.