Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5th Oral Disease - Other > Maxillary Antrum > Flashcards

Maxillary Antrum Flashcards

1
Q

What is the maxillary antrum?

A

The largest paranasal sinus

Pyramidal shaped and bilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is maxillary antrum lined with?

A

Respiratory epithelium = ciliated pseudostratified columnar epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

4 functions of maxillary antrum?

A

Reduce weight of skull
Voice resonance
Humidification
Mucous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does maxillary antrum drain?

A

Drain into nose via ostium (half way up medial wall)
Efficient cilia beat towards ostium

NOT DEPENDENT ON GRAVITY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the anatomical borders of the antrum?

A

Infraorbital border - superior
Alveolar process - inferior
Lateral wall of nose - medial
Zygoma - lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What nerve bundle transverse the roof of antrum?

A

Infraorbital bundle in orbital floor

Branch of maxillary nerve from trigeminal

Sensory innervation - skin lower eyelid, side of nose, nasal septum, part of cheek and upper lip
No motor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What features would you see on medial wall of sinus?

A

Middle and inferior turbinates

Ostium - cilia push mucous = drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What features would you see on the floor of the sinus?

A

Alveolar process of maxilla and the hard palate

Close to apices of teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is there a difference in the floor of the sinus in children and adults?

A

In children alveolus adjacent to nasal floor

In adults 5-10mm lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What would you expect to see on the anterior wall of the maxilla?

A

The cheek
Thinnest part - good surgical access
Canine fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an OAC?

A

Open communication between oral cavity and maxillary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where does floor of sinus extend?

A

Often molar region to canine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is OAC most likely?

A

Palatal root of first molar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What roots have RFs for OAC?

A

Long, divergent, dilacerated or ankylosed roots

Hypercementosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are other RFs for OAC?

A 
Lone standing molar
Loss apical periodical bone
Pneumatisation of sinus 
Impacted upper molar
Cleft lip and palate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What operator technique are RF for OAC?

A

Poor technique - excessive force, wrong instruments
Displacement of foreign object into sinus
Tuberosity fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What pt factors post surgery could lead to OAC?

A

Failure to follow antra regime

Build up of pressure in cavity - nose blowing, sneezing, altitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What teeth are at most clinical risk?

A 
Upper second molar (most risk)
Upper first molar
Upper third molar
Upper secondary premolar
Upper first premolar
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are 3 important factors considering risk of OAC?

A

Thickness of antral floor
Bone resorption related periodontitis
Early and complete increase risk of OAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are signs and symptoms of OAC?

A 
Purulent discharge
Bad taste
Liquid regurgitation through
nose
Air escape
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What test can be used to check for air escape?

A

Valsalvin test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are clinical signs of OAC?

A

Movement of antra lining during respiraton
Bubble from socket during respiration
Hollow sound when aspirating socket
Fogging of mirror
Extracted tooth attached concave bone or tuberosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What radiographic sign can indicate OAC?

A

Defect in sinus floor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is management of OAC less 2mm

A 
Promote spontaneous healing 
Gentle irrigation of socket + debridement of sharp bone 
Resorbable haemostatic agent (Surgicel) 
Suturing loose edges 
Antral regime + review 
Vacuum splint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is management of OAC that is 2-4m?

A

Consider conservative vs surgical repair

Assess- pt clinical signs, general RFs, MH, SH, OH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is management of OAC >4mm

A

Surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the conservative tx of OACs?

A 
Many undetected and will heal spontaneously 
Ab - broad spec (penicillin)
Splint - aid healing
Decongestants
Pt instructions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What pt instructions should you give re OAC?

A

No nose-blowing
No flying altitude, don’t suck straws
Steam inhalation
Good OH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the active tx options of OAC?

A

Suture
Packing (resorbable/ non-resorbable)
Splints

w/ conservative regimen

30
Q

What is OAF?

A

Oral antra fistula

Communication of the oral cavity and maxillary sinus lined by epithelium

31
Q

Difference OAC and OAF?

A

OAF - epithelialised lining develops

32
Q

What are signs/ symptoms of OAF?

A 
Purulent discharge
Bad taste
Liquid regurgitation through nose
Air escape
Episodic sinusitis
Nasal voice
Epistaxis (nose bleed)
Prolapse antra mucosa into mouth
Whistling sound
33
Q

How can OAF be surgically repaired?

A

Buccal advancement flap - most common
Buccal fay pad graft
Palatal rotation

34
Q

How is buccal advancement flap used to tx OAF?

A

Excised OAF lining together w/ antra sinus lining or granulation tissue

35
Q

Why is buccal advancement flap most commonly used for tx of OAF?

A

Good success rate w/ low morbidity

Good blood supply from buccal periosteum

36
Q

Disadv of buccal advancement flap for tx of OAF?

A

Reduction is vestibular sulcus depth - prosthetic implications

37
Q

What is technique for buccal advancement flap for OAF?

A

Full thickness buccal mucoperiosteum flap is raised w/ flared margins to allow for advancement

Advancement to palatal side – periosteal release required in transverse direction

Sutured using vertical mattress

Important sits on sound bone

Palatal mucosa can be incised

OAF need to surgically remove fistula before closed

38
Q

What does buccal fat pad graft for tx of OAF involve?

A

Involve use of highly vascular fat surrounded by buccinator and masseter

Blunt dissection and pulled over to close defect then fat sutured

39
Q

What anatomy do you need to be careful of when using buccal fat pad graft?

A

Parotid duct and papilla - pierce buccinator at anterior border

40
Q

When is buccal fat pad graft useful?

A

Useful for delayed closure of larger defects

41
Q

What does palatal rotation rely on?

A

Greater palatine artery

42
Q

Why is palatal rotation not often used?

A

Painful donor site
Healing by secondary intention
Length/ width ratio important - flap necrosis

43
Q

How to avoid displacement of foreign objects?

A

Awareness - radiograph, awareness of RFs

Avoid apical pressure

44
Q

What are RFs for displacement of object into sinus?

A

RF - age, RCT, ankylosis, proximity

45
Q

What are the most common teeth to be involved in displacement?

A

Upper 6 palatal root
3rd molar - whole tooth
2nd molar root

46
Q

What are the 3 approaches to management of displaced object?

A
  1. Alveolar approach
  2. Caldwell-Luc approach
  3. Functional endoscopic sinus surgery - FESS
47
Q

What radiographs are useful when managing displacement?

A

Intra-oral PA
OPT
CBCT - assess ability of retrieval

Used to diagnose and identify location and extent of displacement

48
Q

When can retrieval be used?

A

When displacement in closer than think - between mucosa and alveolar bone or between sinus lining and floor

Use light and suction

49
Q

What is transalveolar approach?

A

Fill sinus w/ saline and use suction to retrieve

Use flap w/ bone removal to aid visualisation

50
Q

What is Caldwell-Luc procedure?

A

If not obviously retrievable by trans alveolar

Required GA

51
Q

What are pros and cons of Caldwell-Luc procedure?

A

Pro - trapdoor approach = good access and persevere alveolar bone

Con - traumatic, loss vitality adjacent teeth, fistula formation, infra-orbital nerve damage

52
Q

What is procedure of Caldwell-Luc?

A

Raise flap in buccal sulcus above premolar teeth to create lateral window

53
Q

What is FESS?

A

Conservative approach where sinus access via enlarged middle meatus antrosotomy

Minimise associated complications but expensive, time consuming and need skilled operator (ENT)

54
Q

What are 3 management decisions of tx of displaced objects?

A

Retrieve
Delay
Refer

55
Q

What to do if delay tx of displaced object?

A

Document
Radiograph
Ab
Refer

56
Q

Post-op advice when displaced object?

A 
Similar conservative regimen
Decongestants
Abs
Avoidance nose blowing
OH
57
Q

Features of the tuberosity?

A

Most distal aspect of maxilla

Contains socket of third molar

58
Q

Why are fractures of tuberosity a concern?

A

Cause large OAC

Stability issue for later prosthetics

59
Q

What are RFs of fractured tuberosity?

A 
Upper molar XLA
Roots - divergent, dilacerated, ankylosed
Lone standing molar
Pneumatised sinus 
Increased age
Poor technique
60
Q

Why dose increased age increase risk of tuberosity fracture?

A

Antrum larger, expanded, pneumatised - floor lower down

61
Q

What poor techniques can lead to fractured tuberosity?

A

Uncontrolled force
Inadequate maxillary alveolar support
Excessive elevation

62
Q

Clinical signs of fractured tuberosity?

A

Tooth and tuberosity move synchronously w/ XLA
Fracture noise
Palatal tear - bleaching mucosa
Bleeding

63
Q

What does management of tuberosity fracture depend on?

A

If tuberosity attached to periosteum or not

64
Q

How to manage fracture if tuberosity attached to periosteum?

A
  1. Splinting to adjacent teeth
  2. Conservative management - soft diet, ab and re-book for surgical XLA (6-8 weeks)
  3. Section crown to enable roots and tuberosity to heal
  4. Remove fractured tuberosity - subperiosteal dissection off fragment
65
Q

How to manage fractured tuberosity if separated from soft tissue +/- OAC?

A

Smooth sharp edges residual bone

No OAC - suture and antra regime

OAC - tx according to defect size

66
Q

How can implants cause injury to sinus?

A

Inadequate height - injury to sinus floor

Overcome w/ sinus life procedure - increase vertical volume of bone

67
Q

What is an internal sinus lift?

A

Use summers technique

Aim: maintain integrity of sinus lining, limit graft to restore alveolar bone and avoid impaired sinus drainage

68
Q

What is chronic sinusitis?

A

When remains persistent

Can be bacterial or viral

69
Q

Symptoms of chronic sinusitis?

A

Mimic toothache, nasal discharge, pressure/ pain when bending

70
Q

How to tx bacterial sinusitis?

A

Abs

Decongestants

71
Q

How to tx chronic sinusitis?

A

Antra wash
Nasal surgery
ENT referral - esp if recurrent

5th Oral Disease - Other (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions