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Novel approaches for oroantral communication closure: A literature review
1
Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
2
Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
Corresponding author
Agnieszka Balicz
Katedra i Zakład Chirurgii Stomatologicznej, Wydział Nauk Medycznych w Zabrzu ŚUM, pl. Akademicki 17, 41-902 Bytom
Katedra i Zakład Chirurgii Stomatologicznej, Wydział Nauk Medycznych w Zabrzu ŚUM, pl. Akademicki 17, 41-902 Bytom
Ann. Acad. Med. Siles. 2026;80:203-211
KEYWORDS
oroantral communicationoroantral fistulaplatelet-rich fibrinconcentrated growth factorsbiomaterialsregenerative dentistrymaxillary sinusoral surgery
TOPICS
ABSTRACT
Introduction:
Oroantral communication (OAC) and oroantral fistula (OAF) are common complications of maxillary posterior tooth extraction. Although conventional flap techniques remain effective, they are associated with postoperative morbidity, anatomical alterations, and limitations in patients requiring future implant rehabilitation. Regenerative and biomaterial-based approaches have emerged as potential alternatives. The aim of this study is critically evaluate the clinical effectiveness, safety, and indications of novel regenerative and biomaterial-based techniques for OAC and OAF closure.
Methods:
A systematic search of PubMed/MEDLINE, Scopus, and Embase was conducted for human clinical studies published between 2000 and 2025. Randomized controlled trials, non-randomized clinical studies, cohort studies, and case series (≥5 patients) assessing regenerative or biomaterial-based closure methods were included. Due to heterogeneity, a qualitative synthesis was performed.
Results:
Autologous blood-derived products, particularly platelet-rich fibrin and concentrated growth factors, achieved high closure success (90%–100%) in small-to-medium defects (≤5 mm) with reduced postoperative pain and enhanced healing. Heterologous and synthetic biomaterials enabled simultaneous defect closure and bone regeneration, while combined approaches were most suitable for larger defects or planned implant rehabilitation.
Conclusions:
Regenerative and biomaterial-based approaches are effective adjuncts or alternatives to conventional flaps in selected cases. However, evidence quality remains limited, highlighting the need for standardized, controlled clinical trials.
Oroantral communication (OAC) and oroantral fistula (OAF) are common complications of maxillary posterior tooth extraction. Although conventional flap techniques remain effective, they are associated with postoperative morbidity, anatomical alterations, and limitations in patients requiring future implant rehabilitation. Regenerative and biomaterial-based approaches have emerged as potential alternatives. The aim of this study is critically evaluate the clinical effectiveness, safety, and indications of novel regenerative and biomaterial-based techniques for OAC and OAF closure.
Methods:
A systematic search of PubMed/MEDLINE, Scopus, and Embase was conducted for human clinical studies published between 2000 and 2025. Randomized controlled trials, non-randomized clinical studies, cohort studies, and case series (≥5 patients) assessing regenerative or biomaterial-based closure methods were included. Due to heterogeneity, a qualitative synthesis was performed.
Results:
Autologous blood-derived products, particularly platelet-rich fibrin and concentrated growth factors, achieved high closure success (90%–100%) in small-to-medium defects (≤5 mm) with reduced postoperative pain and enhanced healing. Heterologous and synthetic biomaterials enabled simultaneous defect closure and bone regeneration, while combined approaches were most suitable for larger defects or planned implant rehabilitation.
Conclusions:
Regenerative and biomaterial-based approaches are effective adjuncts or alternatives to conventional flaps in selected cases. However, evidence quality remains limited, highlighting the need for standardized, controlled clinical trials.
ADDITIONAL INFORMATION
Use of AI tools statement: Grammarly AI was used for language correction.
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