Incidence and risk factors of oroantral perforation following tooth ex- traction among Nigerian population in a tertiary hospital: a ten- year retrospective study

Ekaniyere Benlance, Birch Dauda SAHEEB


Oro-antral perforation (OAP) could be misdiagnosed if the incidence and risk factors are unknown and its consequence could be worrisome. We aimed to determine the incidence and risk factors of oro-antral perforations after teeth extraction. A retrospective study of forceps extracted upper posterior teeth over a ten-year period from September 2008 to November 2018 was done at our hospital in Nigeria. In univariate analysis, the predictors were age, gender, experience of surgeon, site of tooth, side of surgery, use of elevators while the outcome variable was oroantral perforations. Logistic regression was also done to determine the risk factors associated OAP. We used SPSS Version 17(SPSS Inc, Chicago, USA) to perform descriptive and inferential statistical analysis. P-Value less than 0.05 was considered statistically significant. Out of the total 26,372 dental extractions during the ten-year period, 54 (0.2%) extraction cases (33 males, 21 females) had oro-antral perforations. Their mean age was 54.8± 10.6years (ranging from 21 to78 years). The highest incidence occurred in the sixth decade of life. Only the location of teeth had a significant association with oro-antral perforations. The location of upper first molar was (OR = 1.85, P=0.00) identified as a significant risk factor. The incidence of OAP is significantly lower in Nigerians and was 0.2% although there could be a population variability. The position of the upper first molar was a factor found to be associated and predictive of the OAP but age, gender, number of extractions per visit, side of operation and the surgeon’s experience were not. The findings will help surgeons to predict occurrence of OAP knowing its risk factors.



incidence, oro-antral perforation, risk factors, simple tooth extraction

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Killey HC, Kay LW. An analysis of 250 cases of oro-antral fistula treated by buccal flap operation. Oral Surg Oral Med Oral Pathol 1967, 24: 726-739.

Punwutikorn J, Waikakul A, Pairuchvej V. Clinically significant oroantral communications - A study of incidence and site. Int J Oral Maxillofac Surg 1994; 23:19-21.

Von Wowern N. Frequency of oro-antral fistulae after perforation to the maxillary sinus. Scand J Dent Res 1970; 78(5):394-6.

Ehrl PA. Oroantral communication. Epicritical study of 175 patients, with special concern to secondary operative closure. Int J Oral Surg 1980; 9:351-8.

Rothamel D, Wahl G, d’Hoedt B, Nentwig GH, Schwartz F Becker J. Incidence and predictive factors for perforation of the maxillary antrum in operations to remove upper wisdom teeth: prospective multicentre study. Br J Oral Maxillofac Surg 2007; 45:387-391.

Amaratunga NAS. Oroantral fistulae - a study of clinical, radiological and treatment aspects. Br J Oral Maxillofac Surg1986. 24:433–437.

del Rey-Santamaria M, Valmaseda CE, Berini AL, Gay EC. Incidence of oral sinus communications in 389 upper third molar extraction. Med Oral Patol Oral Cir Bucal 2006; 11:334-8..

Hasegawa T, Tachibana A, Takeda D et al. Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth. Oral Maxillofac Surg 2016; 20: 369-375.

Dym H, Wolf JC. Oroantral communication. Oral and Maxillofac Surg Clinics N Am 2012;24: 239-247

Demetoglu U, Ocak H, Bilge S. Closure of Oroantral Communication with Plasma-Rich Fibrin Membrane. J Craniofac Surg2018. 29: 367-370.

Al-Juboori MJ, Al-Attas MA, Magno Filho LC. Treatment of chronic oroantral fistula with platelet-rich fibrin clot and

collagen membrane: a case report. Clin Cosmet Investig

Dent2018; 10:245-249.

Bilginaylar K. The Use of Platelet-Rich Fibrin for

Immediate Closure of Acute Oroantral Communications: An Alternative Approach. J Oral Maxillofac Surg2018; 76:278-286.

Światkowski W, Rahnama M, Zebrowska E, Baszak J .Investigation on oroantral communication rate. Dental and Medical Problems 2014; 51(2):173-177

Arrigoni J,Lambrecht JT. Komplikationen bei und nach operative weisheitzahnentfernung (complication during and after third molar extraction) . Schweiz Monatsschrzahnmed2004; 114:171-86.

Hirata Y, Kino K, Nagaoka S, Miyamoto R, Yoshimasu H, Amagasa S. A clinical investigation oro-maxillary sinus perforation due to tooth extraction. Kokubyo Gakkai Zasshi 2001; 68: 249-53.

Bodner L, Gatot A, Bar-Ziv J. Technical note: oroantral fistula: improved imaging with a dental computed tomography software program. Br J Radiol1995; 68:1249- 50.

Guven O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg1998; 26:267-71.

Hernando J, Gallego L, Junquera L, Villarreal P. Oroantral communications. A retrospective analysis. Med Oral Pathol Cir Bucal 2010; 15:499-503.

Mohammed JA. Oroantral communication - A Clinical and radiographic retrospective study of 39 Iraqi patient. MDJ 2013; 10:88-94.

Abuabara A, Cortez AL,Passeri LA, de Moraes M ,Moreire RW. Evaluation of different treatment for oroantral/ oronasal communication: experience of 112 cases. Int j oral and Maxillofac surg 2006;35:155-8

Beckedorf H, Sonnabend E. The incidence of maxillary sinus perforation in teeth extraction. Zahnartztl Rudsch 1954;66:566-9.

Hanihara T. Comparison of craniofacial features of major 24. Fraco- carro B, Barona –Dorado C, Martinez- Gonzalez

human groups. Am J Phys Anthropol1996; 99: 389-412. 23. Marszal K.The significance of selected anatomical details of the maxillary sinus in dental treatment planning – a

literature review. Dental Forum2013;41:69-74

MJ, Rubio-AlonsoLJ,Martinez-Gonzalez JM. Meta- analytic study on the frequency and treatment of oral antral communication. Med Oral Pathol Cir Bucal 2011; 16:682- 7.



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