OAC Clinical Test — ORE Part 1 MCQ

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EasyOral SurgeryOAC Clinical TestORE Part 1

Following extraction of an upper molar, an oro-antral communication is suspected. Which simple clinical test is most appropriate to confirm it?

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Correct answer: E — Observe the socket while the patient gently exhales with the nostrils pinched

**A is correct.** With a suspected oro-antral communication after upper molar extraction, ask the patient to exhale *gently* with the nostrils pinched while observing the socket. Air escape or bubbling through the socket indicates a communication with the maxillary sinus. The manoeuvre should be gentle; forceful blowing is unnecessary and may enlarge the defect. Percussion and cold testing assess the periapical and pulpal condition of adjacent teeth, not sinus patency. Syringe aspiration is not a routine confirmatory test and risks disturbing the socket. Cheek transillumination is not a reliable test for a post-extraction oro-antral communication. Clinical assessment may be supplemented by appropriate imaging where the diagnosis or extent remains uncertain.

Reference: Shahrour R, Shah P, Withana T, et al. Oroantral communication, its causes, complications, treatments and radiographic features: A pictorial review. Imaging Science in Dentistry. 2021. https://pubmed.ncbi.nlm.nih.gov/28859924/