Pathogenesis (development of disease)
Mouth-antrum junction most commonly develops as an intraoperative (“during a surgical procedure”) complication of surgical procedures:
- During extraction (tooth removal) of upper premolars (small molars) or molars (molars).
- During their root tip resection
- During the surgical removal of upper wisdom teeth.
- After the removal of tumors on the palate
Caused by anatomically unfavorable oroantral positional relationship: the floor of the maxillary sinus is identical to the cranial (“upward”) boundary of the hard palate and has its deepest region at the level of the first molars. Often, only a thin, partially porous bone lamella runs between the roots of the teeth and the maxillary sinus (maxillary sinus), which can also be dissolved by inflammatory processes.
Favouring factors:
- Chronic peri-/apical periodontitis (inflammation of the periodontium (tooth-supporting apparatus) just below the tooth root; apical = “tooth rootward”; perical “around the tooth root”) (granuloma, cyst, osteomyelitis/bone marrow inflammation).
- Long tooth roots
- Far caudal (“downward”) bulge of the maxillary sinus (maxillary sinus)
Etiology (causes)
Biographical causes
- Unfavorable anatomic conditions
Behavioral causes
- Failure to follow the behavioral recommendations given after plastic coverage of an MAV for ten days can lead to the formation of an oroantral fistula:
- Nasal blowing
- Sneezing with mouth closed
- Abandonment of decongestant measures
Causes due to disease
- Chronic apical periodontitis of an upper premolar or molar to be removed.
- Tumors on the palate
Operations
- Extraction of upper premolars and molars
- Surgical removal of upper wisdom teeth
- Root apex resection
- Tumor removal
