Treatment of Odontogenic Sinusitis With Oroantral Communication and Fistula: A Systematic Review and Meta-Analysis

To assess the available data regarding medicinal, surgical, and combination therapy approaches for odontogenic sinusitis linked to OAC and OAF. Oroantral communication (OAC), an atypical connection between the oral cavity and maxillary sinus, commonly arises following upper jaw procedures, trauma, or infection. Chronic odontogenic maxillary sinusitis may result from OAC developing into an oroantral fistula (OAF) if treatment is not received. Recurrent infections and functional difficulties can be avoided by managing these illnesses effectively.

A systematic search was conducted in National Library of Medicine's (PubMed [MEDLINE]) and Google Scholar for studies published between 2000 and 2024. A total of 174 articles were initially identified. After applying inclusion and exclusion criteria and performing full-text screening, 5 observational studies were included. Data extraction followed a standardized template, meta-analysis was conducted to compare success, failure, and adverse event rates across treatment modalities.

Five observational studies, including 459 patients were analyzed. The surgical and medical groups' treatment outcomes did not differ statistically significantly (OR = 3.24; 95% CI: 0.23, 46.18), with initial heterogeneity resolved through sensitivity analysis (I² reduced from 82% to 1%). Similarly, failure rates did not differ significantly between groups (OR = 0.60; 95% CI: 0.01, 486.7), though high heterogeneity remained (I² = 92%). Adverse events were minimal and comparable across groups (Risk Difference = 0; 95% CI: -0.08, 0.08), with no observed heterogeneity (I² = 0%). Overall, both treatment approaches demonstrated similar efficacy and safety profiles.

Both medical and surgical interventions appear effective in managing odontogenic sinusitis related to OAC and OAF. To create standardized treatment regimens and evaluate long-term results, more controlled research is required.