Healing time for sinus exposure



posted March 23, 2001 10:27 PM 

      Exposed sinus with extraction tooth #2, 6+ mm diameter opening.
      Anyone with similar experience know approximate healing time?
      The only time I ever seem to hear about these cases is when
      patients develop an infection or adverse symptoms, but in our
      case, so far so good

posted March 24, 2001 06:27 AM 

      Welcome to the world of oral surgery. Healing time for these
      cases over a normal course is 2yrs. for bone. If you have a good
      soft tissue closure and the pt doesn't traumatise the site things
      will be ok in about 3-6months. A sinus perf this small heal pretty
      well. Post op xrays in 1 month will tell you if you are getting
      closure or not.

      These things happen more often than you think. Good soft tissue
      closure is a must. I find that Augmenten (clavumox) works well in
      control of post op infections. - Pontic 

posted March 24, 2001 09:54 PM

      I agree with Pontic 110%.

      Most times will close on it's own, but don't assume it will...

      If you didn't gain primary closure, get 'em back yesterday and do so 
      with a wide-based and well undermined full-thickness buccal flap,
      excising any granulation tissue on palatal margin and that buccal
      flap margin, suture with non-resorbable, and have 'em back in 10-14
      days for inspection and suture removal. No nose-blowing.

      Inform patient, and refer to OS or periodontist if it doesn't close,
      to CYA.

      Been there, my friend, don't panic. Just do the right thing!

      Marshall

posted March 24, 2001 10:56 PM

      Excellent Marshall,

      BUT you forgot to tell 'em one important thing. Don't just do the flap 
      and suture over the exposure -- you could likely get a dehissence 
      (Marshall, how bad did I butcher that word -- you're the 'word genius' 
      around here) over the sinus exposure, and you'd be right back where you 
      started. On the palatal tissue, remove, or external bevel the tissue so 
      that the intact full thickness buccal flap extends PAST the sinus exposure 
      going toward the palate, and the flap approximates the palatal tissue over 
      'intact' tissue below it.

      Like Marshall said, be SURE you free up that buccal full thickness flap 
      -- may want to incise the periosteum in the apex of the vestibular fold -- 
      this frees up the flap big time.

      Rod
      Rodger 'Rod' Kurthy
      23032 Alicia Parkway, SteD
      Mission Viejo, CA 92692
      drrodger@home.com