The double-barrier technique using platelet-rich fibrin for closure of oroantral fistulas

Abstract

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.

Treatment of Odontogenic Maxillary Sinusitis with the Use of Growth Factors in Advanced Platelet-Rich Fibrin for Immediate Closure of Oro-Antral Communication: A Case Report

“…The most frequently utilized treatment for OAC and OAF involves a combination of platelet-rich fibrin and a tension-free buccal flap, or alternatively, the sole use of PRF. The results of treatment with growth factors were very good and all patients had good healing in follow-up [30][31][32][33][34][35][36][37][38][39][40][48][49][50][51][52][53][54][55]. In our patient, we also achieved very good treatment results and, additionally, healing of inflammatory lesions in the maxillary sinus in the case of odontogenic chronic sinusitis.…”