Maxillary tuberosity fracture as a post operative complication- a case report

Author: 
Sunil Vasudev, Shaiqua Nooreen and Maneesha Shree

Maxillary tuberosity sometimes lead fracture because of tooth fusion, prominent or curved roots, Root Ankylosis, chronic periapical infection, hypercementosis.
Fracture of the maxillary tuberosity sometimes can happen when pneumatization of the maxillary sinus extends between the roots of upper molars. Fracture of the maxillary tuberosity is a potential sequela of removal of maxillary posterior teeth. Often, a small fragment of bone is able to be carefully dissected from its periosteum and delivered with the tooth. However, in cases of a large bony fragment, tearing the fragment from its periosteum and delivery with the tooth can result in serious complications.
Such a complication may lead to oroantral fistula or serious infection, which may result in maxillary necrosis or deafness. Fracture of the maxillary tuberosity is not an uncommon complication of removal of maxillary molar teeth.
The incidence of fracture during third molar removal alone has been reported to be at around 0.6%.
Fragile vessels in the region of the posterior maxilla and tuberosity are easily ruptured when bone is fractured and separated from its periosteum. Deafness, the most frightening complication, mayalso occur because of tuberosity fracture. Cattlin (7) reported that, after maxillary tuberosity fracture, deafnessoccurred from the disruption of the pterygoidhamulus and the tensor veli palatine, in turn collapsingthe opening of the eustachian tube. The patient also suffered permanent restricted mandibular movementsDeafness, the most frightening complication, mayalso occur because of tuberosity fracture. Cattlin (7)reported that, after maxillary tuberosity fracture, deafness occurred from the disruption of the pterygoidhamulus and the tensor veli palatine, in turn collapsing the opening of the eustachian tube. The patient alsosuffered permanent restricted mandibular movements. Deafness, the most frightening complication, may also occur because of tuberosity fracture. Cattlin (7) reported that, after maxillary tuberosity fracture, deafness occurred from the disruption of the pterygoid hamulus and the tensor veli palatine, in turn collapsing the opening of the eustachian tube.
The patient also suffered permanent restricted mandibular movements. Deafness, the most frightening complication, mayalso occur because of tuberosity fracture. Cattlin (7) reported that, after maxillary tuberosity fracture, deafness occurred from the disruption of the pterygoidhamulus and the tensor veli palatine, in turn collapsingthe opening of the eustachian tube. The patient alsosuffered permanent restricted mandibular movements because of the disruption of the pterygoid muscles an. Deafness, the most frightening complication, may also occur because of tuberosity fracture. Cattlin (7) reported that, after maxillary tuberosity fracture, deafness occurred from the disruption of the pterygoidhamulus and the tensor veli palatine, in turn collapsing the opening of the eustachian tube. The patient also suffered permanent restricted mandibular movementsbecause of the disruption of the pterygoid muscles an In this case report we showcase fracture of maxillary tuberosity followed by extraction which lead to palatal defect and for the closure of defect palatal pedicalflap and buccal rotation flapis used. The procedures utilizing buccal mucoperiosteal flap for closure include straight-advancement flap, rotation-advancement flap, transverse flap and sliding flap techniques. Double-layer closure utilizing local tissues include the combination of inversion and rotational advancement flaps, double overlapping hinged flaps, double island flaps and superimposition of reverse palatal and buccal flaps. The most common methods used for closure of OAF are the buccal flap and the palatal pedicled flap technique

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DOI: 
http://dx.doi.org/10.24327/ijcar.2022.923.0209
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