OAC Diagnosis — ORE Part 1 MCQ

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EasyOral SurgeryOAC DiagnosisORE Part 1

During extraction of an upper premolar, the patient notices air passing between the extraction socket and the nose. Which complication has occurred?

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Correct answer: D — Oro-antral communication

The correct answer is **A. Oro-antral communication**. This is an abnormal opening between the oral cavity and maxillary sinus. It is a recognised complication of extraction of upper posterior teeth, including premolars, because their roots can be close to the sinus floor. Air passing from the socket towards the nose is the discriminating clinical feature and demonstrates a patent communication. A dentigerous cyst is associated with the crown of an unerupted tooth and would not cause air movement through a fresh socket. Acute sinus drainage may produce fluid but does not itself explain a new air passage. The nasopalatine duct is in the anterior midline palate, remote from a premolar socket. Major salivary ducts are also not at risk in this surgical field.

Reference: Countess of Chester Hospital NHS Foundation Trust. Maxillofacial Unit: Oro-Antral Communication (OAC) Advice Leaflet, accessed July 2026. https://plr.cht.nhs.uk/download/1418/Oro%2520antral%2520communication%2520OAC%2520A4