A sinus communication may occur following upper molar extraction, implant placement, or trauma.

If not closed properly, it can progress to a chronic oroantral fistula and maxillary sinus infection.

Referral is indicated when:

• There is nasal air escape through the socket or fluid discharge into the mouth.

• The socket fails to heal or the patient develops sinus symptoms.

• OPG or CBCT confirms sinus floor perforation.

Oral and maxillofacial surgeons can perform surgical closure using buccal or palatal advancement flaps and manage any associated sinusitis.

Prompt management prevents chronic infection and the need for more complex reconstruction.

When to refer to AWOMS Oral and Maxillofacial Surgery: Any suspected sinus communication after upper molar or implant procedure - early closure yields the best outcome.