The effectiveness of buccal advancement flap versus platelet-rich fibrin in closing oroantral communications. (A prospective randomized clinical study)

Study ObjectiveThis study aimed to evaluate and compare the clinical efficacy of platelet-rich fibrin (PRF) clots versus the conventional buccal advancement flap (BAF) technique in the closure of delayed oroantral fistulas (OAFs), with a focus on the integrity of defect closure (tight versus open) and overall wound healing outcomes.Materials and MethodsThis randomized controlled study enrolled 20 patients presenting with persistent OAFs exceeding 5 mm in diameter. Participants were randomly allocated into two equal groups. The test group (n = 10) received autologous PRF clots applied directly to the defect, whereas the control group (n = 10) underwent closure via a buccal advancement flap. Postoperative healing was prospectively monitored over 21 days, with clinical endpoints including complete epithelialization, defect closure, and patient-reported outcomes.ResultsAt the 21-day postoperative assessment, successful closure was observed in 90% of the PRF group and 80% of the BAF group. In the PRF group, data analysis revealed that defect size decrease was a statistically significant predictor of healing success. Moreover, the PRF group demonstrated superior wound healing outcomes compared to the BAF group, with the difference reaching statistical significance (p = 0.005).ConclusionsPlatelet-rich fibrin (PRF) has emerged as a promising biomaterial in the management of delayed oroantral communications, offering a minimally invasive and biologically driven alternative to conventional surgical interventions. Its inherent capacity to promote accelerated soft tissue regeneration, coupled with enhanced patient comfort and reduced postoperative morbidity, underscores its potential as a superior modality in the closure of oroantral defects.