Oral surgery II: Part 2. The maxillary sinus (antrum) and oral surgery

Key Points

  • On many occasions the maxillary sinus (antrum) is in close proximity to surgical sites in the mouth and can therefore become involved in operative complications.

  • The clinician must be familiar with common pathology affecting the maxillary sinus.

  • An outline of the pathological conditions affecting the maxillary sinus is provided.

  • Indications for sinus surgery are outlined.

Abstract

The maxillary sinus is the largest of the four paranasal sinuses and, being anatomically adjacent to the dentate region of the maxilla, is commonly a source of problems – not simply in terms of conditions affecting the sinus but also in establishing an accurate diagnosis. As anyone who has suffered both sinusitis and a dental abscess in the posterior maxilla will tell you, the symptoms are almost indistinguishable. For this reason, a sound understanding of the maxillary sinus is an essential requisite for all dentists.

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Figure 1
Figure 2: Relative anatomy and ostium leading into the nasal cavity in the middle meatus of the lateral nasal wall.
Figure 3
Figure 4: Immediate closure of an oroantral communication.
Figure 5: a) Dental panoramic tomograph (DPT) of opaque left maxillary antrum.
Figure 6: Repair of oroantral fistula once the antral regime has been implemented and the antrum decongested.
Figure 7: Buccal fat pad advancement.
Figure 8: Buccal fat pad flap.
Figure 9
Figure 10: Tuberosity fracture.
Figure 11: Displaced implants.
Figure 12: Caldwell-Luc approach.
Figure 13
Figure 14
Figure 15: a) Left sectional DPT of a large radicular cyst on a non-vital upper left 6.
Figure 16

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Acknowledgements

Our thanks to Mr David Roberts, ENT Consultant Kings Health Partners for reviewing the chapter.

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Correspondence to T. Renton.

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Renton, T., Durham, J. & Hill, C. Oral surgery II: Part 2. The maxillary sinus (antrum) and oral surgery. Br Dent J 223, 483–493 (2017). https://doi.org/10.1038/sj.bdj.2017.858

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