ABSTRACT Oronasal fistulae are common complication following palatoraphy. There are several surgical procedures to repair oronasal fistulae. However, conventional oronasal fistulae closure technique is not always possible, especially when the surrounding tissue is replaced by fibrotic tissue due to previous palatoraphy. Tissue defects in oronasal fistulae should be replaced with tissues providing good vascularisation such as pedicle tongue flap. A case of pedicle tongue flap used to close oronasal fistulae was reported. Eleven-year-old girl, presented with oronasal fistulae and bilateral alveolar cleft after previous palatoraphy. The oronasal fistulae were closed with pedicled tongue flap. The healing was uneventful, and the division of the pedicle tongue flap was done three weeks later and closed primarily. There was no dehiscence of the wound and masticatory functions were recorded. Vascularised flap such as pedicle tongue flap is a preferred technique to close oronasal fistulae after palatoraphy.
Dental Fistula ; Surgical Flaps

Recently, alloy dental implant is frequently performed in dentistry. The complications of a dental implant include maxillary sinusitis, oroantral fistula, displacement of implants and others. Maxillary sinusitis among these complications is one of the severe complications, which is being reported to occur rarely. The complications of dental implant are often accompanied by gingival swelling, pain, fistula and other symptoms, for which immediate therapeutic measures may be implemented. Nevertheless, as the authors encountered, overlooking secondary nasal symptoms of a dental implant may lead patients to rely merely on drug treatment without realizing the particular causes for such symptoms. The authors experienced a case with acute unilateral maxillary sinusitis developed after dental implant performed at the dental clinic, which was alleviated by performing endoscopic sinus surgery. Such complication has been rarely reported overseas, nor domestically. By reporting this case, we aimed to call attention to the complication of sinusitis and to take into consideration of implant displacement in suspicious cases of acute maxillary sinusitis.
Alloys ; Dental Clinics ; Dental Implants* ; Dentistry ; Fistula ; Humans ; Maxillary Sinus* ; Maxillary Sinusitis* ; Oroantral Fistula ; Sinusitis

This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment.
Dental Pulp Cavity ; Fistula ; Follow-Up Studies ; Incisor* ; Microscopy ; Tooth

The aim of this study was to systematically investigate the complications of single implant-supported restorations followed more than 5-year. Thirty-five studies were selected for the systematic review. A total of 3932 single implants were included at the beginning of studies. Thirty-one implants were removed before loading and 91 implants after loading. The overall implant loss rate was 3.1 %. Implant losses were concentrated on the period between loading and 2-year follow-up, and, after a stable period, increased after 5-year follow-up. The mean marginal bone loss at single-tooth implants was well within 0.2 mm/year, i.e., acceptable annual bone loss by the implant success criteria. However, considerable amounts of single implants suffered a marginal bone loss at implant more than 0.2 mm/year. Fistula was a frequent biological complication in the early studies. The most frequent technical problem was a screw loosening, but its frequency was reduced after the use of a gold screw and torque controller. Within the limits of this study, the complications of single implants might be underestimated due to the lack of information about the biological and technical complications available in the relevant literature.
Dental Implants, Single-Tooth ; Fistula ; Follow-Up Studies ; Torque

Oroantral fistula (OAF), also termed oroantral communication, is an abnormal condition in which there is a communicating tract between the maxillary sinus and the oral cavity. The most common causes of this pathological communication are known to be dental implant surgery and extraction of posterior maxillary teeth. The purpose of this article is to describe OAF; introduce the approach algorithm for the treatment of OAF; and review the fundamental surgical techniques for fistula closure with their advantages and disadvantages. The author included a thorough review of the previous studies acquired from the PubMed database. Based on this review, this article presents cases of OAF patients treated with buccal flap, buccal fat pad (BFP), and palatal rotational flap techniques.
Adipose Tissue ; Dental Implants ; Fistula ; Humans ; Maxillary Sinus ; Mouth ; Oroantral Fistula ; Tooth

A cutaneous sinus tract of odontogenic origin occurs when purulent by-products of dental pulp necrosis spread along the path of least resistance from the root apex to the skin on the face. Patients presenting with this condition usually visit a dermatologist first, as the lesion can mimic various dermatologic pathologies, ranging from an epidermal cyst to basal cell carcinoma. The location of the sinus in the head and neck region should lead the dermatologist to seek a dental origin in order to avoid misdiagnosis. The lesion may persist for long periods before a correct diagnosis is made and the odontogenic source is treated appropriately. Herein, we report a case of a cutaneous sinus tract of odontogenic origin.
Carcinoma, Basal Cell ; Dental Fistula ; Dental Pulp Necrosis ; Diagnosis ; Diagnostic Errors ; Epidermal Cyst ; Head ; Humans ; Neck ; Pathology ; Skin

dental arch, provides bone for eruption of permanent teeth or placement of dental implants, and gives support to the lateral ala of the nose. Closure of residual oronasal fistula can occur simultaneously. Repair of alveolar clefts can occur at a variety of stages defined as primary, early secondary, secondary, and late. Most centers perform this surgery as secondary bone grafting. Autogenous bone provides osteogenesis, osteoinduction and conduction and is recommended for grafting to the cleft alveolus and several donor sites are available. The surgeon should select the best flap design considering the amount of mucosa available, blood supply and tension-free closure, and the extent of the oronasal communication. The authors provide a comprehensive understanding of alveolar clefts and their repair by reviewing the historical perspective, objectives for treatment, timing, source of graft, presurgical orthodontics, surgical techniques, postoperative care, and complications.]]>
Bone Transplantation ; Dental Arch ; Dental Implants ; Fistula ; Humans ; Mucous Membrane ; Nose ; Orthodontics ; Osteogenesis ; Postoperative Care ; Tissue Donors ; Tooth ; Transplants

Many different type of embolic material, such as muscles Gelfoam, porcelain, and detachable balloon, etc, has been used for the treatment of carotid-cavernous fistula. In an effort to achieve better results the authors used laminaria, a sea-weeds root, as a newly-tried embolus which has a unique characteristic of expanding gradually within 4 hours 3-4 times from its original width, but not in length, when in contact with any type of fluid. A very special feature of the laminaria is that the initial hard and coarserness is slowly transformed while expanding into a rounded softness as to allow no menhanical injury to the surrounding vessels of tissue. The laminaria was formed into a reversed bowling-pin shape measuring 8x1.5mm with tapered tail and a round head in which contains a sliver clip as a radiographic marker. An extension of standard angiographic technique ahs been used to complete an alternative method of treatment. This technique involves introducing the cather harboring the laminaria by the percutaneous route either transfemoral or directly transcarotid and releasing the terminal internal carotid artery at the site of the fistula. Releasing a few of the shaped laminaria piece from the catheter tip has resulted in a successful obliteration of the fistula in 7 cases out of total 8 of carotid-cavernous fistula.
Carotid Artery, Internal ; Catheters ; Dental Porcelain ; Embolism ; Fistula* ; Gelatin Sponge, Absorbable ; Head ; Laminaria* ; Muscles

Migration of dental implants into the maxillary sinus is uncommon. However, poor bone quality and quantity in the posterior maxilla can increase the potential for this complication to arise during implant placement procedures. The aim of this report is to present a dental implant that migrated into the maxillary sinus and disappeared. A 53-year-old male patient was referred to us by his dentist after a dental implant migrated into his maxillary sinus. The displaced implant was discovered on a panoramic radiograph taken five days before his referral. Using computed tomography, we determined that the displaced dental implant was not in the antrum. There was also no sign of oroantral fistula. Because of the small size of the displaced implant, we think that the implant may have left the maxillary sinus via the ostium.
Dental Implants* ; Dentists ; Humans ; Male ; Maxilla ; Maxillary Sinus* ; Middle Aged ; Oroantral Fistula ; Referral and Consultation

The purpose of this study was to assess the incidence of flare-ups among patients who received endodontic treatment and to examine the correlation with pre-operative and operative variables. Analysis was in two aspects (a) overall incidence of flare-ups as expressed by a percentage of all patients visits and (b) percentage of flare-ups that occurred as related to various factors such as patient demographics, diagnosis, and treatment procedures. 1. From the 840 teeth which were examined in this study, the total number of flare-ups was 13. 2. As to gender of patients, there was no significant difference in flare-ups. 3. As to tooth groups, there was no significant difference in flare-ups. 4. In the teeth with pre-operative symptom, there was a statistically significant higher incidence of flare-ups than the teeth without it. 5. In the teeth with apical periodontitis, there was a statistically significant higher incidence of flare-ups. 6. As to pulp and periapical status, non-vital teeth had a higher incidence as compared with vital teeth, irreversible pulpitis. 7. Multi-visit treatment resulted in the higher incidence of flare-ups than one visit treatment. 8. Re-treatment procedures had a statistically significant higher incidence of flare-ups than root canal treatment. In this study, overall percentages of flare-ups was 1.55%. It showed a statistically significant higher incidence related to pre-operative symptom, apical periodontitis, and re-treatment. There was no significant difference in flare-ups related to gender, tooth groups, and fistula.
Demography ; Dental Pulp Cavity ; Diagnosis ; Fistula ; Humans ; Incidence* ; Periapical Periodontitis ; Pulpitis ; Tooth