16 April 2026 : Review article
Systematic Review of Case Reports and Case Series Published Between 2015 and 2025 on the Use of Biomaterials for Closure of Oroantral Fistula
Fareedi Mukram Ali
ABDEG 1, Ahmed Shaher Alqahtani AE 1, Ali Mohammed Makrami BCEFG 2, Nouf I. Odabi BCDEG 3, Ali Atiyah Derbishi BCDEG 3, Sultan Hassan Hakami BCDEF 3, Amr Jali BCDEG 3, Alami Mohammed Alamir CDEG 4, Khurshid Mattoo CDEF 5*
DOI: 10.12659/MSM.952194
Med Sci Monit 2026; 32:e952194
Table 1 Biomaterials used for oroantral fistula (OAF) closure in the past 10 years (2015 to 2025).
| Sl. No. | Author, year, country (when known) | Patient age/sex/ tooth No: | Patient factors | OAF etiology | OAF size/location | Follow-up | Material used | Patient-based outcome and conclusion |
|---|---|---|---|---|---|---|---|---|
| 1 | Adamska et al [], 2024, Poland10 | 28/M#27 | No systemic diseases | Chronic odontogenic maxillary sinusitis, periapical lesion | Extensive OAC | 24 hours, 14 days,10 months | Advanced platelet-rich fibrin (A-PRF) | OAC closure with A-PRF resulted in pain relief at tooth 27 |
| 2 | Helal et al [], 2024, Egypt11 | 20/F#16 | No systemic diseases | OAC, maxillary sinus | Large bone defect with OAC | 2 weeks, 4 weeks, 6 months | CAD-CAM allogenic bone block | Closure of OAC achieved; pain relieved |
| 3 | Yotsava et al [], 2024, Bulgaria12 | 45/M#17, 28 | Multiple myeloma IgG λ, stage I ISS | Radicular cyst, extraction | OAC>5 mm, extraction of #28 | 1 month in both cases | Collagen cone (Collacone); Non-resorbable d-PTFE (Permamem), Dense polytetra-fluoro-ethylene (d-PTFE) membranes | Successful OAC healing; mastication pain resolved |
| 4 | Park et al [], 2024, South Korea13 | 57/M; 43/M; 66/F2 quadrant | Smoker, no systemic diseases | Sinus graft infection | Recurrent OAF | 12 months, 6 months | Cortical bone shell graft, collagen membrane, Ti-reinforced d-PTFE membrane (Cytoplast, USA) | OAF recurrence resolved, no air leakage, implant placement possible |
| 5 | Salas et al [], 2024, Colombia14 | 56/F#26 | No systemic diseases | Post-extraction | OAC of 7 mm | 6 months | Collagen sponge, hydroxyapatite, Ribose, Collagen membrane | OAC closure achieved; pain relieved |
| 6 | Jung et al [], 2023, South Korea15 | 47/M, 48/M2 quadrant | No systemic diseases | Tooth extraction; dental implant removal | Not specified | 2 weeks, 3 months | Platelet-rich fibrin | Chronic OAF closure resulted in symptom relief |
| 7 | Pal et al [], 2022, India16 | 22/M#26 | No systemic diseases | Tooth extraction (4–5 years ago) | Not specified | 6 months | Platelet-rich fibrin, guided tissue regeneration membranes | Nasal discharge and food regurgitation ceased after OAC coverage |
| 8 | Baek et al [], 2021, South Korea17 | 36/F#17 | Pericarditis, long-term steroid use | Tooth extraction | >20 mm | 2 months, 6 months | Sinus bone grafting, collagen membrane with an allograft | Successful healing; pus and swelling eliminated |
| 9 | Cheng and Tatakis [], 2020, USA18 | 55/M#13 | No systemic diseases | Implant explantation | 5mm | 13 months | Collagen membrane strip, bone allograft | Ridge preservation achieved through OAC repair |
| 10 | Al-Juboori et al [], 2018, Iraq19 | 32/M#16 | No systemic diseases | Tooth extraction | Chronic OAF | 3 months | Platelet-rich fibrin, collagen membrane | Repaired extraction site opening; soft-tissue healing achieved |
| 11 | Chen and Chang [], 2019, Taiwan20 | 53/M#15 to 17 and #41 to 46 | Squamous cell carcinoma (right side of tongue). | Chemo-radiotherapy | Osteora-dionecrosis, OAF | 10 months | Platelet-rich fibrin | Healing was smooth; no more pus around the teeth |
| 12 | Sharma [], 2019, Saudi Arabia21 | 45/M#16 | Chronic smoker, no systemic disease | Tooth extraction 6 months back | Large, long-standing OAF | 1 month | Chin graft, buccal fat pad, buccal advancement flap | Nasal liquid leakage ceased; OAF healed |
| 13 | George [], 2018, USA22 | 77/M#14 | Smoker, systemic health not specified | Surgical sequelae of sinus lift | 14×10 mm large defect | 9 days | Buccal fat pad, platelet-rich fibrin, buccal advancement flap | Novel technique for chronic OAF |
| 14 | Assad et al [], 2017, Syria23 | 29/M, 44/F#16 for both | Not specified | Tooth extraction | Large open socket | 1, 4, and 8 weeks | Platelet-rich fibrin | Effective OAC closure corrected air leakage and vocal resonance |
| 15 | de Souza Lopes et al [], 2015, Brazil24 | 41/M#26 palatal | Not specified | Gunshot projectile wound | Not specified | 6 months | Occlusal splint (3 months), then mesh/palatal flap | Complete closure of OAF and tissue repair |
| 16 | Lakshmi et al [], 201525 | 29/F#27 | Not specified | Tooth extraction | 4–6 mm diameter | 14 days | Human amniotic membrane | Closure of OAF, nasal regurgitation of stopped. |
| 17 | Diachkova et al [], 202026 | 46/F#26 | Not specified | Tooth extraction | Not specified | 1, 3, 6, and 12 months and 8 years | Bovine collagen (“Collost”, BioFarmaHolding, Moscow, Russia) | Nasal liquid leakage during drinking ceased |
| 18 | Kumar et al [], 202227 | 32/F#26 | Not specified | Periapical cyst enucleation | Not specified | 1 to 6 months | Gelfoam and collagen membrane | Left upper back tooth swelling subsided |