Risk factors in oroantral communication while extracting the upper third molar: Systematic review

Lewusz-Butkiewicz, Katarzyna; Kaczor, Kinga; Nowicka, Alicja

doi:10.17219/dmp/80944

Cited by 18 publications

(17 citation statements)

References 13 publications

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“…One systematic review evaluated several risk assessment studies assessing the risk of OAC based on clinical data, panoramic radiography, or cone-beam computer tomography (CBCT) utilizing statistical models. The authors concluded that panoramic radiographies are not reliable for assessing risk factors for OAC compared to CBCT based on current evidence [ 5 ]. We could confirm this finding by applying multiple deep-learning algorithms and letting experts evaluate the preoperative panoramic radiography.…”

Section: Discussionmentioning

confidence: 99%

“…The maxillary sinus can have variable anatomy due to maxillary sinus septa, temporary mucosal swelling, previous operations (Caldwell–Luc operation), or tumors [ 4 ]. Two-dimensional radiographic imaging is the standard imaging for routine extraction of maxillary teeth [ 5 ]. Panoramic radiography is the most widely used imaging modality for common oral surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to the general overview of the maxilla and mandible in a 2D X-ray/panoramic radiography, it is also characterized by its high availability, low radiation exposure, and low cost compared to 3D cone beam computer tomography [ 6 , 7 ]. Surgical intervention is required when the mucosal perforation exceeds 3 mm [ 5 ]. To be able to treat this complication, preoperative planning is necessary, such as planning the incision to be able to form a possible mucoperiosteal flap [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Artificial Intelligence-Based Prediction of Oroantral Communication after Tooth Extraction Utilizing Preoperative Panoramic Radiography

et al. 2022

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Oroantral communication (OAC) is a common complication after tooth extraction of upper molars. Profound preoperative panoramic radiography analysis might potentially help predict OAC following tooth extraction. In this exploratory study, we evaluated n = 300 consecutive cases (100 OAC and 200 controls) and trained five machine learning algorithms (VGG16, InceptionV3, MobileNetV2, EfficientNet, and ResNet50) to predict OAC versus non-OAC (binary classification task) from the input images. Further, four oral and maxillofacial experts evaluated the respective panoramic radiography and determined performance metrics (accuracy, area under the curve (AUC), precision, recall, F1-score, and receiver operating characteristics curve) of all diagnostic approaches. Cohen’s kappa was used to evaluate the agreement between expert evaluations. The deep learning algorithms reached high specificity (highest specificity 100% for InceptionV3) but low sensitivity (highest sensitivity 42.86% for MobileNetV2). The AUCs from VGG16, InceptionV3, MobileNetV2, EfficientNet, and ResNet50 were 0.53, 0.60, 0.67, 0.51, and 0.56, respectively. Expert 1–4 reached an AUC of 0.550, 0.629, 0.500, and 0.579, respectively. The specificity of the expert evaluations ranged from 51.74% to 95.02%, whereas sensitivity ranged from 14.14% to 59.60%. Cohen’s kappa revealed a poor agreement for the oral and maxillofacial expert evaluations (Cohen’s kappa: 0.1285). Overall, present data indicate that OAC cannot be sufficiently predicted from preoperative panoramic radiography. The false-negative rate, i.e., the rate of positive cases (OAC) missed by the deep learning algorithms, ranged from 57.14% to 95.24%. Surgeons should not solely rely on panoramic radiography when evaluating the probability of OAC occurrence. Clinical testing of OAC is warranted after each upper-molar tooth extraction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Artificial Intelligence-Based Prediction of Oroantral Communication after Tooth Extraction Utilizing Preoperative Panoramic Radiography

et al. 2022

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“… 3 A limitation of 2-dimensional imaging, however, is the superimposition of anatomical structures. 3 8 Figure 2 is a panoramic radiograph of a 73-year-old man who came in for a routine dental check-up. After the clinical exam was performed, a panoramic image was obtained.…”

Section: Two-dimensional Versus Three-dimensional Imaging In Diagnosing Oacmentioning

confidence: 99%

Oroantral communication, its causes, complications, treatments and radiographic features: A pictorial review

Shahrour¹,

Shah²,

Withana³

et al. 2021

Imaging Sci Dent

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Purpose An oroantral communication (OAC) is an abnormal space between the maxillary sinus and oral cavity. The causes, complications, treatment, and radiographic features of OAC in 2-dimensional and 3-dimensional imaging modalities are discussed. Materials and Methods This pictorial review presents a broad spectrum of imaging findings of OAC. Representative radiographs depicting OAC were chosen from our database. PubMed was used to conduct a comprehensive literature search of OAC. Results Characteristic features of OAC include discontinuity of the maxillary sinus floor, thickening of the maxillary sinus mucosa, or a combination of both. Two-dimensional imaging modalities are the method of choice for identifying discontinuities in the maxillary sinus floor. However, 3-dimensional imaging modalities are also essential for determining the status of soft tissue in the maxillary sinus. Conclusion The integration of 2-dimensional and 3-dimensional imaging modalities is crucial for the correct diagnosis and comprehensive treatment of OAC. However, the diagnosis of OAC must be confirmed clinically to prevent unnecessary mental and financial burdens to patients

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confidence: 99%

Clinical and Radiographic Assessment of cyanoacrylates Opposing Buccal sliding flap for the immediate repair of Oroantral communication

Khairy

Abulmagd

2020

OMX

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Oro-antral communication (OAC) is the inevitable connection between the oral cavity and the maxillary sinus. The most reputable cause of the condition is the extraction of maxillary molars due to the close proximity of their roots to the antral floor which is very thin in this area [1,2] . Moreover, periapical infection, large cysts, tumors and trauma can all be potential causes of oroantral communication [3,4] . It is of utmost importance to close this patent connection as soon as it is recognized to preclude the development of sinusitis with subsequent fistula formation [5] . Several articles recommended the closure of this communication within 24 hours of the incident [6] .Affirmation on the presence of OAC is established through several procedures comprised of clinical examination including Valsalva test, Cheek blowing test and probing of the perforation site through the socket however, this specific technique is not favored anymore as it is associated with several complications as increasing size of the defect and the possible pushing of foreign bodies or bacteria into the maxillary sinus [7,8] . Clinical diagnosis must be followed by radiological confirmation to exclude the presence of any dental roots or foreign bodies near or within the vicinity of the antrum. Radiographs provide accurate assessment of the site and size of the defect. Radiographic maneuvers commonly used are periapical, panoramic view [9] . Computerized Tomography (CT) as well as Cone beam computerized Tomography (CBCT). Nowadays, CBCT is widely used due its high quality, available 3D images, low radiation dose and the accurate details with less artifacts than helical ABSTRACT Introduction: Oroantral communication is an uncommon, inadvertent incident resulting from various causes the most common of which is the extraction of upper molars. Immediate closure of the communication is highly recommended to avoid infection and subsequent fistulous tract formation. Cyanoacrylate tissue glue was introduced as a reliable method for flapless sealing of the communication without any of the complications associated with the surgical maneuvers. One of the oldest surgical procedures used for closure of the Oroantral communication is the buccal advancement flap which proved efficiency in complete closure of the defect with minimal related complications. Aim of the study: The study aims evaluate the immediate flapless closure of Oroantral communication using cyanoacrylates versus the buccal sliding advancement flap. Patients and Methods: Twenty patients suffering from instant oroantral communication were included in the study. CBCT was performed to each of them to confirm the diagnosis, patients were divided into two groups where Group I (Study group) patients were treated by sealing of the defect using periacry l90 HV while Group II (control group) patients performed Buccal sliding advancement flap. Clinical follow up including pain, facial swelling, recurrence of the defect and sulcular depth up were performed at day 1, 3, 7, 15 and 1 month. CBCTs were...

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Risk factors in oroantral communication while extracting the upper third molar: Systematic review

Cited by 18 publications

References 13 publications

Artificial Intelligence-Based Prediction of Oroantral Communication after Tooth Extraction Utilizing Preoperative Panoramic Radiography

Artificial Intelligence-Based Prediction of Oroantral Communication after Tooth Extraction Utilizing Preoperative Panoramic Radiography

Oroantral communication, its causes, complications, treatments and radiographic features: A pictorial review

Clinical and Radiographic Assessment of cyanoacrylates Opposing Buccal sliding flap for the immediate repair of Oroantral communication

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