Clinical and radiographic findings in maxillary sinus with oro-antral fistula

The purpose of the present study was to estimate: (1) the diagnostic value fo the primary clinical and radiographic examinations as to the condition in the antral mucosa in cases of an oroantral fistula; and (2) the value of a radiographic follow-up of cases with uneventful, successful surgical closure of the fistula. The material consisted of 52 patients with an oro-antral fistula. The condition of the antral mucosa was examined before and during the surgical operation. Postero-anterior and lateral radiographs of the paranasal sinuses, orthopantomograms and intraoral dental films were taken of each patient and also in 10 cases of uneventful, successful closure after 1 year. This analysis shows that: (1) the primary clinical diagnosis of the condition in the antral mucosa corresponds to the real diagnosis; (2) false negative radiographs are rare; (3) false positive radiographs will occur in 22% - 63% of cases without maxillary sinusitis; and (4) radiographic follow-up of uneventful, successful cases can be omitted. In conclusion, the primary clinical examination is most reliable and superior to radiographs in proof/disproof of maxillary sinusitis, pre- and postoperatively.