Comprehensive treatment of oroantral junctions

Abstract

Introduction. The study studied the complex effect of drug and surgical treatment of oroantral junctions (OAS). In practical dentistry, a combination of methods for treating OAS is used, in particular conservative, surgical and combined approaches. Treatment depends on the etiology, size of the defect, the patient's condition and the presence of concomitant pathology. Special importance is given to complex methods that include a combination of reconstructive techniques with the use of modern biomaterials and technologies.Objective of the research. Analysis of modern approaches to the complex treatment of oroantral junctions, assessment of their effectiveness and determination of optimal strategies aimed at restoring tissue integrity.Materials and methods. A comparative clinical analysis of methods for eliminating oroantral communication (OAC) in patients with chronic odontogenic maxillary sinusitis was conducted. The study included 18 patients aged 25-55 years, of whom 6 were women and 12 were men. The patients were divided into two groups: a control group (10 individuals operated on using the mobilized buccal flap technique) and a main group (8 individuals who underwent palatal subepithelial vascularized flap plastic surgery).The effectiveness of the methods was evaluated based on the following criteria: the risk of edema and bleeding in the postoperative period, the presence of scar deformities, paresthesia, and soft tissue changes in the long term. General clinical methods (inspection, palpation, probing, percussion), a bibliographic method (for source analysis), comparative analysis methods, and statistical data processing were used.Results and discussions. During the analysis of the results, it was determined that the technical complexity of the proposed technique was higher, which in turn affected the duration of the surgical intervention by an average of 30 minutes, compared to 20 minutes when using a mobilized buccal flap. Bleeding from the branches of the palatine artery was observed in one patient operated on using the new concept. In 4 patients operated on using the mobilized buccal flap method (control group), paresthesias were noted in the infraorbital area for 4 weeks. Postoperative edema and soft tissue hematomas were found in 20% of patients in this observation group and in none of the group operated on using our method. Scar deformities and deterioration of the soft tissue biotope in the surgical area were noted in 100% of cases with the surgical technique using a mobilized buccal flap and were not detected in the main group.Conclusions. Complex treatment of oroantral junction, including surgical closure of the defect and medical treatment, is the most effective approach that minimizes the risk of complications and reduces the duration of rehabilitation. Further studies should be aimed at improving materials for defect reconstruction and developing new protocols for combined treatment.