Source:Journal of Oral and Maxillofacial Surgery
Author(s): Kani Bilginaylar
Currently, buccal advancement flap, palatal rotational flap or buccal fat pad techniques are frequently used to close an oroantral communication (OAC). In this study,platelet rich fibrin (PRF) clots were used for immediate closure of acute oroantral communications after the extraction of posterior maxillary molars. Acute oroantral perforations of more than 3 mm in diameter in 21 patients were treated uneventfully by using PRF clots. None of the patients had systemic diseases nor symptoms of sinus disease. After tooth extraction, the diagnosis of acute oroantral communication was examined by Valsalva's maneuver test (compression of nostrils with the fingers and blowing out the air). After the detection of an air leak, modification of a ball burnisher instrument of 3 mm diameter was used to determine whether the size of perforation was greater than 3 mm. The post-extraction socket of the tooth was cleaned with a sterile physiologic saline solution, and the cavity was filled with PRF. PRF clots were sutured to the gingiva to prevent them from migrating to the sinus and for stabilization. On the 7th day of follow-up, healthy granulation tissue was observed, and on the third week of follow-up, epithelialized oral mucosa was detected at the extraction site across all cases. This technique (PRF) enables the closure of OACs without a primary flap closure or any other surgical interventions. Thus, the use of PRF for immediate closure of acute OACs will make the treatment of OACs less traumatic and easier and will eliminate the need for special surgical expertise.
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