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.


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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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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