Oro-antral fistula is a complication of a failed implant and/or an extraction in the upper molar areas. With sinus elevation procedures becoming more and more common, the failure and subsequent infection of the sinus floor has become more common and therefore more oro-antral fistulas are seen in practice.
When the communication of oral cavity and sinus cavity occurs the best surgical practice is to attempt its’ closure as soon as it occurs. In this case, the sinus cavity surface of the communication will be lined with ciliary epithelium and the oral cavity side of it will be covered by keratinize mucosal epithelium. Depending on the thickness and diameter of the bony opening, the communication can include a boney sinus floor or remain fiberous. If this communication is not repaired at once, the mucosal and antral epithelium will grow into the opening and prevent the subsequent closure of the tract.
Once the tract is epithelized, very delicate and thorough procedure is needed to de-epithelize the tract and facilitate closure of the communication.