OROANTRAL COMMUNICATION RESULTING FROM THIRD MOLAR EXTRACTION: A LITERATURE REVIEW

Abstract

Buccosinusal communication (BSC) is one of the most frequent complications resulting from the extraction of maxillary third molars, characterized by an abnormal opening between the oral cavity and the maxillary sinus. This integrative literature review aimed to analyze risk factors, diagnostic methods, and therapeutic approaches related to this condition. The main predisposition arises from the anatomical proximity between dental roots and the sinus floor, intensified by maxillary pneumatization, inadequate tooth position, and the surgical technique employed. Diagnosis is established through clinical examination—including the Valsalva maneuver—and imaging tests, with cone-beam computed tomography being considered the gold standard for accurately assessing the extent of the communication. Treatment involves immediate closure using mucoperiosteal flaps, grafts, or collagen membranes, with the buccal fat pad flap being recommended for more complex cases to prevent complications such as chronic sinusitis and oroantral fistula formation. Preventive strategies are based on careful surgical planning, detailed radiographic evaluation, and the use of minimally invasive techniques. It is concluded that the effective management of BSC requires thorough knowledge of regional anatomy, early diagnosis, and appropriate therapeutic intervention, ensuring better clinical outcomes and improved patient care quality.