Lamia Yahya M. Alshowail

Background/Objectives: To compare the effects of different surface treatments on the color and translucency of three types of zirconia ceramics. Methods: Ninety CAD/CAM-milled zirconia disks (10 mm diameter, 1 mm thickness) were fabricated from Cercon HT (3-YTZP), IPS e.max ZirCAD MT (4-YTZP), and Cercon XT (5-YTZP). Baseline CIE Lab* coordinates were measured using a digital spectrophotometer. The disks underwent one of three surface treatments: 50 µm alumina air-particle abrasion (AAA), Zircos-E etching (ZE), or 100 µm glass bead air-particle abrasion (GBA). Post-treatment CIE Lab* measurements were obtained, and color change (ΔE₀₀, CIEDE2000) and translucency change (ΔTP₀₀) were calculated. Results: Regarding color change (ΔE₀₀), 50 µm AAA produced the greatest change, followed by ZE, while GBA caused the smallest change. Surface treatment and its interaction with material type were found to exert a significant effect, whereas material type alone was not significant. Cercon XT showed the highest numerical ΔE₀₀ value among the materials, although the difference was not statistically significant. All ΔE₀₀ values were below the clinical acceptability threshold (00) after surface treatment. Baseline translucency values (TP₀₀) differed significantly, with Cercon XT being the most translucent, followed by ZirCAD MT and Cercon HT, but these differences did not result in significant ΔTP₀₀ changes post treatment. Conclusions: Surface treatments and their interaction with material type significantly affected zirconia color change, with 50 µm alumina air-particle abrasion producing the most pronounced effect. Material type alone did not significantly influence ΔE₀₀, though Cercon XT showed the highest numerical value. Translucency change (ΔTP₀₀) after treatment was unaffected by surface treatment or material–treatment interaction.

Oroantral fistula (OAF) is a persistent pathological communication between the oral cavity and the maxillary sinus, often arising as a complication of dental extractions, trauma, or surgical procedures involving the maxilla. Despite various treatment options, a standardized, algorithmic approach remains lacking. To develop and present a comprehensive, evidence-based clinical decision-making algorithm for the diagnosis and management of OAF based on defect size, chronicity, sinus involvement, and infection status. A narrative review and synthesis of the literature were conducted, evaluating diagnostic modalities, microbiological profiles, and both conservative and surgical treatment options from 1990 to 2025. The resulting data informed the development of a stepwise flowchart that integrates clinical parameters and radiographic findings to guide practitioners in selecting the most appropriate therapeutic approach. The algorithm begins with an initial assessment including patient history, clinical and radiographic evaluation. Small asymptomatic OAFs (< 2 mm) are managed conservatively with hygiene protocols and nasal precautions. Infected small fistulas warrant antibiotics. Medium-sized OAFs (5–10 mm) in favorable locations are treated with local flaps, whereas large or unfavorably located fistulas (> 10 mm) require advanced surgical techniques such as buccal fat pad grafts, distant flaps, and regenerative materials like platelet-rich fibrin. Sinus health and chronicity are considered pivotal in determining treatment timing and method. This algorithm provides a structured, patient-centered framework for the management of OAF. By incorporating anatomical, pathological, and microbiological factors, it enhances clinical decision-making, improves treatment outcomes, and supports interdisciplinary coordination.