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

The removal of the upper third molar is a procedure commonly performed in oral and maxillofacial surgery. Maxillary third molars are generally less difficult to extract than mandibular third molars. The surgical removal of maxillary third molars is usually associated with low complication rates and low morbidity. This procedure involves the risk of developing complications such as oroantral communication, displacement into adjacent anatomic spaces, fracture of the maxillary tuberosity, and root fracture. Orthopantomograms are the standard preoperative imaging modality, but there is no proven tool for predicting oroantral communication. New possibilities have been offered by cone-beam computed tomography, which is increasingly used in dentistry and is an innovative technique that provides more information as it eliminates the superimposition of surrounding structures and allows the acquisition of 3-dimensional images and their qualitative assessment. The aim of this systematic review was to assess risk factors during the extraction of the upper third molar using orthopantomograms and cone-beam computed tomography.