Prevalence of Oro-Antral Communications Following Posterior Maxillary Extractions at Nnamdi Azikiwe University Teaching Hospital, Nnewi

Oro-antral communication (OAC) is a well-recognized complication of posterior maxillary tooth extraction, resulting from unintentional perforation of the maxillary sinus floor. If unrecognized and untreated, OAC can progress to oro-antral fistula and chronic maxillary sinusitis, causing significant morbidity. This prospective observational study quantifies the prevalence of OAC following posterior maxillary extractions and identifies associated risk factors at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, South East Nigeria. Over an eight-month period, 312 consecutive posterior maxillary tooth extractions were evaluated intraoperatively and at one-week postoperative review. Patient factors including age, sex, tooth type, root morphology on preoperative radiograph, indication for extraction, and operator experience were recorded. OAC was detected in 5.1% of extractions, with upper second and third molar extractions showing the highest incidence. Dilacerated or divergent roots in close proximity to the sinus floor on preoperative radiograph were significantly associated with OAC occurrence. Less experienced operators demonstrated a higher OAC rate independent of tooth type. Most OACs were managed successfully with buccal advancement flap closure. The study emphasizes the critical role of preoperative radiographic assessment and informed surgical planning in preventing and managing this complication. Keywords: oro-antral communication, maxillary sinus, posterior extraction, Nnewi, South East Nigeria.