Final answer:
An oroantral communication often occurs with the removal of maxillary first molars due to the proximity of their roots to the floor of the maxillary sinus. It is less likely in elderly patients due to less pneumatized bone.
Step-by-step explanation:
An oroantral communication is a condition where there is an opening between the oral cavity and the maxillary sinus. When considering the likelihood of an oroantral communication occurring, it is important to understand the anatomy of the maxillary sinus and its relation to the teeth. The oroantral communication occurs more often with the removal of maxillary first molars. This is because the roots of the first molars can be closely associated with the floor of the maxillary sinus, and their removal can lead to an opening into the sinus, especially if pneumatization (expansion of the sinus into the alveolar bone) has occurred. Pneumatization creates a thinner bone separating the sinus from the tooth roots, thus increasing the risk during tooth extraction.
Elderly patients tend to have less pneumatized bone due to bone density loss with aging, which can decrease the likelihood of an oroantral communication forming during tooth extraction. However, each case can vary, and careful assessment prior to any dental surgery is vital to minimize the risk of such complications.