KoreaMed, a service of the Korean Association of Medical Journal Editors (KAMJE), provides access to articles published in Korean medical, dental, nursing, nutrition and veterinary journals. KoreaMed records include links to full-text content in Synapse and publisher web sites.
1Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Kyung Hee University College of Dentistry, Seoul, Korea
An oroantral fistula (OAF) or oroantral communication (OAC) is an opening between the oral cavity and the maxillary sinus. If left untreated, these openings may cause chronic maxillary sinusitis. Although small defects (diameter <5 mm) may close spontaneously, larger communications require surgical intervention. Various studies have been conducted on OAC closure using a platelet-rich fibrin (PRF) membrane; most of these prior studies have involved simple direct application of PRF clots. This study introduces a new “double-barrier technique” using PRF for closure of an OAF involving sinus mucosal lifting and closure. The PRF material is inserted into the prepared maxillary sinus space, and the buccal advancement flap covers the oral side. This technique was successfully used to treat two patients with chronic OAF in the posterior maxillary region after implant removal or tooth extraction. The use of a PRF membrane in a double-barrier technique may have advantages in soft-tissue healing and could enable easy closure of chronic OAF with minimal trauma.
Fig. 1
A schematic of the incision line (A), antral flap rotation and elevation as the first barrier (B), platelet-rich fibrin (PRF) insertion into the prepared maxillary sinus space (C), a buccal advancement flap as the second barrier (D).
Fig. 2
A. A pre-surgery panoramic radiograph of Patient No. 1. B. The cone-beam computed tomography view. C. A view of the oroantral fistula from the oral side. D. The view of the elevated and sutured sinus mucosa. E. A view of the platelet-rich fibrin clots inserted as a membrane. F. The view of the sutured buccal advancement flap. G. A view from the oral side at two weeks postoperatively. H. A view from the oral side at two months after surgery.
Fig. 3
A. A pre-surgery panoramic radiographs of Patient No. 2. B. The cone-beam computed tomography view. C. A view of the oroantral fistula from the oral side. D. The view of the elevated sinus mucosa. E. A view of the platelet-rich fibrin clots inserted as a membrane. F. The view of the sutured buccal advancement flap. G. A view from the oral side at two weeks postoperatively. H. A view from the oral side at two months after surgery.
10. Obradovic O, Todorovic L, Pesic V. 1981; Investigations of the buccal sulcus depth after the use of certain methods of oro-antral communication closure. Bull Group Int Rech Sci Stomatol Odontol. 24:209–14. PMID: 6948590.
12. Kitagawa Y, Sano K, Nakamura M, Ogasawara T. 2003; Use of third molar transplantation for closure of the oroantral communication after tooth extraction: a report of 2 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 95:409–15. https://doi.org/10.1067/moe.2003.122. DOI: 10.1067/moe.2003.122. PMID: 12686925. Article
15. Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, et al. 2006; Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 101:e37–44. https://doi.org/10.1016/j.tripleo.2005.07.008. DOI: 10.1016/j.tripleo.2005.07.008. PMID: 16504849. Article
16. Sabri H, Sarkarat F, Mortezagholi B, Aghajani D. 2022; Non-surgical management of oro-antral communication using platelet-rich fibrin: a review of the literature. Oral Surg. 15:455–64. https://doi.org/10.1111/ors.12685. DOI: 10.1111/ors.12685. Article