The Treatment and Management of Oroantral Communications and Fistulas: A Systematic Review and Network Metanalysis

Abstract

Objectives: The aim of this work was to systematically review and carry out a statistical metanalysis to identify the best treatment for close oroantral communications and fistulas and to avoid the risk of recurrence. Materials and Methods: An electronic search was conducted on the MEDLINE database (Pubmed), Scopus, and Google scholar using the following keywords: “oro antral communication (OAC)” OR “oro antral fistula (OAF)” OR “antro-oral communication” OR “communication between maxillary sinus and oral cavity” OR “oro-sinusal communication” OR “oro-sinusal fistula” OR “sinus communication” OR “sinus fistula” OR “antral communication” AND “treatment” OR “management” OR “surgical treatment” OR “surgical interventions”. This work was performed in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). After article screening, 9 RCTs (randomized controlled trials), comparing two or more techniques, were included in this review. Results: A statistically significant difference was detected in favor of the buccal fat pad compared to the buccal advancement flap and palatal rotational flap. Conclusions: With the limitations of this study, the buccal fat pad showed the best results in terms of communication closure and reducing the risk of relapse.

Keywords

• oroantral communication
• oroantral fistula
• maxillary sinus
• soft tissue local flaps
• buccal fat pad