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Perforation defects of the alveolar processes of the upper jaws
Last reviewed: 07.07.2025
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Perforation defects of the alveolar processes of the upper jaws occur most often when the upper premolars and molars are removed, immediately or after a few days, manifesting themselves with the following symptoms:
- when tilting the head down and to the healthy side, blood (immediately after tooth extraction), water or food (some time after this operation) is released from the nasal cavity;
- the patient cannot “puff out” his cheeks, play wind instruments, blow his nose, or clearly pronounce the sounds p, b, v;
- when trying to exhale through the nose with the nostrils pinched, bubbles are visible in the area of perforation; if it arose against the background of acute purulent sinusitis, in this case pus is abundantly released from the alveoli, and if against the background of chronic polyposis, a polyp may protrude.
[ Treatment of perforation defects of the alveolar processes of the upper jaws
Treatment depends on the disease that caused the perforation of the oral cavity with the maxillary sinus. If the mucous membrane of the sinus is not inflamed, the perforation can be immediately eliminated with a pedicle flap facing either the vestibule of the mouth or (if the vestibule is small or deformed by scars) the palate.
In case of inflammation of the mucous membrane of the maxillary sinus, appropriate conservative treatment of sinusitis is first carried out until a “clean” washing fluid is obtained (with irrigation of the sinus through a perforation hole); then a typical trepanation of the maxillary sinus is performed through the Wassmund-H. I. Zaslavsky approach, revision of the alveolus (removal of root remnants, sequestration, alveolar granulation) and the defect is eliminated using plastic surgery.