Surgical approaches to oroantral fistula

Oralantral fistula is defined as an epithelialized pathological connection between the oral cavity and the maxillary sinus, with a multifactorial etiology. Reduction of smell and taste, post-nasal exudate, epistaxis, halitosis and pain in the region of the upper elements are some of the main signs and symptoms reported. In some cases, the fistula may regress spontaneously. However, when it does not regress, the indicated treatment is surgical and the approach to be used depends on factors such as size, location, presence or absence of infection and the patient's oral health conditions. In case of infection, drug therapy of amoxicillin with clavulanate associated with mouthwashes with chlorhexidine gluconate, anticongestants and even antifungal treatment if necessary should be indicated in the preoperative weeks. The aim of the study was to evaluate surgical approaches for the treatment of oroantral fistulas in order to guide clinical practice. For this, a literature review was carried out in the Pubmed database. After analyzing the articles using the inclusion and exclusion criteria, 13 articles were selected for data extraction. The surgical approaches found can be categorized into autogenous soft tissue and bone grafts, allografts, xenografts, synthetic materials and other techniques. From the results found, it is possible to conclude that there is more than one approach that can provide success in the treatment of oroantral fistulas. Therefore, it is essential to understand them, evaluating indication, advantage and disadvantage, in order to carry out the most appropriate approach for each case of oroantral fistula.