Non-surgical management of an oro-antral fistula in a patient with HIV infection.
BACKGROUND
The risk of post-extraction complications is higher in patients who are immunosuppressed compared to other patients with normal immune function. In addition, invasive dental procedures are more likely to have serious complications in these patients. This case report demonstrates an effective non-surgical procedure to treat an oro-antral fistula in an HIV-infected man.


METHODS
The oro-antral fistula was de-epithelialized under local anaesthesia and the patient wore a surgical splint continuously, removing it only for cleaning, for an eight week period. Chlorhexidine gel was regularly applied to the fitting surface of the splint and the oro-antral communication. The patient was reviewed on a regular basis.


RESULTS
This procedure resulted in resolution of the patient's symptoms within two weeks. Complete healing of the oro-antral fistula was evident following eight weeks of wearing the surgical splint.


CONCLUSIONS
This procedure provided an effective method of treating an oro-antral fistula in an immunocompromised patient without causing any detrimental effects to the patient's overall health. Adequate pre-surgical assessment of patients prior to extractions is important in all patients to help prevent the occurrence of such complications.
Logan
R M
RM
Medically Compromised Patient Unit, Adelaide Dental Hospital, South Australia. richard.logan@adelaide.edu.au
Coates
E A
EA
D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage*; D017742:Dental Care for Chronically Ill / Q000379:methods*; D015658:HIV Infections; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009957:Oroantral Fistula / Q000188:drug therapy*; D010516:Periodontal Splints
D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine