Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Jun;27(6):2713-2724.
doi: 10.1007/s00784-022-04846-7. Epub 2023 Jan 6.

Platelet-rich fibrin vs. buccal advancement flap for closure of oroantral communications: a prospective clinical study

Stefan Hunger  1   2 , Stefan Krennmair  1   3 , Gerald Krennmair  4 , Sven Otto  5 , Lukas Postl  6   7 , Danilo-Marc Nadalini  2
Affiliations
Randomized Controlled Trial

Platelet-rich fibrin vs. buccal advancement flap for closure of oroantral communications: a prospective clinical study

Stefan Hunger et al. Clin Oral Investig. 2023 Jun.

Abstract

Objectives: The primary aim was to evaluate the success of the defect closure (tight or open) of oroantral communications (OAC) after treatment with platelet-rich fibrin (PRF) clots or a buccal advancement flap (BAF). Secondary outcome measurements were the evaluation of the wound healing, the displacement of the mucogingival border (MGB), and the pain level.

Material and methods: Fifty eligible patients with an OAC defect larger than 3 mm were randomly assigned to either PRF (test group, n = 25) or BAF (control group, n = 25) for defect closure. In a prospective follow-up program of 21 days, the defect closure healing process, the wound healing course using Landry's wound healing index (score: 0-5), the displacement of the MGB, and the postoperative pain score were evaluated.

Results: Five patients in each group were lost to follow-up resulting in 40 patients (20 in each group) for continuous evaluation. On postoperative day 21 (study endpoint), no difference regarding success rate (defined as closure of OAC) was noticed between the test (90%; 18/20) and control group (90%; 18/20). A univariate analysis showed significant differences for age and defect size/height for the use of PRF between successful-tight and open-failed defect healing. At the final evaluation, a significantly (p = 0.005) better wound healing score, a lower displacement of the MGB as well as lower pain-score were seen for the use of PRF.

Conclusions: Based on the findings of the current study, the use of platelet-rich fibrin represents a reliable and successful method for closure of oroantral communications. The use of PRF clots for defect filling is associated with lowered pain levels and less displacement of the mucogingival border.

Clinical relevance: The defect size should be taken into account when choosing the number and size of PRF plugs.

Keywords: Buccal advancement; Closure of oroantral communications; Healing; Lukas Postl and Danilo-Marc Nadalini contributed equally to this work.; Mucogingival border; Platelet-rich fibrin.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Picture during treatment shows the production of PRF: Centrifugation results in a fibrin clot (PRF) in the center of the tube. Red blood cells collect at the base of the tube and acellular plasma is located at the top layer of the tube (The three areas are indicated by white lines)
Fig. 2
Fig. 2
Clinical picture during treatment: an extraction socket in region 26 is shown directly after the placement of a PRF clot
Fig. 3
Fig. 3
Patient of the PRF group with an OAC in region 27 (left side: postoperatively, center: 1 week post op, right side: 3 weeks post op)
Fig. 4
Fig. 4
Patient of the BAF group with an OAC in region 16 (left side: postoperatively, center: 1 week post op, right side: 3 weeks post op)
Fig. 5
Fig. 5
Success of defect closure
Fig. 6
Fig. 6
Clinical healing course for the test and the control group on day 7 and day 21 evaluated using the Landry wound healing index
Fig. 7
Fig. 7
Postoperative pain
Fig. 8
Fig. 8
Number of painkillers used per day
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bennett RJ, Moore JR. An investigation into the pathology and treatment of oro-antral fistulae of dental origin. J Laryngol Otol. 1954;68(8):535–549. doi: 10.1017/S0022215100049963. - DOI - PubMed
    1. Logan RM, Coates EA. Non-surgical management of an oro-antral fistula in a patient with HIV infection. Aust Dent J. 2003;48(4):255–258. doi: 10.1111/j.1834-7819.2003.tb00040.x. - DOI - PubMed
    1. Nezafati S, Vafaii A, Ghojazadeh M. Comparison of pedicled buccal fat pad flap with buccal flap for closure of oro-antral communication. Int J Oral Maxillofac Surg. 2012;41(5):624–628. doi: 10.1016/j.ijom.2011.11.011. - DOI - PubMed
    1. Parvini P, Obreja K, Sader R, Becker J, Schwarz F, Salti L. Surgical options in oroantral fistula management: a narrative review. Int J Implant Dent. 2018;4(1):40. doi: 10.1186/s40729-018-0152-4. - DOI - PMC - PubMed
    1. Borgonovo AE, Berardinelli FV, Favale M, Maiorana C. Surgical options in oroantral fistula treatment. Open Dent J. 2012;6:94–98. doi: 10.2174/1874210601206010094. - DOI - PMC - PubMed

Publication types

LinkOut - more resources