Closure / Repair of Oroantral Fistula (OAF) Caused by Bone Loss Around Dental Implants

Oroantral Fistula is a pathological abnormal communication between the oral cavity and the maxillary sinus which may arise as a result of bone loss and infection from teeth, dental implants, or as the result of trauma or cancer surgery. The symptoms include air escape through the sinus and fluid drainage through the nose.

This patient was referred for evaluation of a communicating hole from her mouth to the maxillary sinus following failure of dental implants. Her dental implants had chronic peri-implantitis with continued loss of bone. Dental implants ultimately became loose. She noted drainage of fluid from her mouth to her nose due to the existing hole through her sinus (Oroantral Fistula or OAF).

For treatment, a soft tissue closure or repair was performed. For this, a small island of flap is created using the tissue from the adjacent cheek area. Once the recipient site is prepared, the soft tissue flap is repositioned and sutured in place. A platelet rich fibrin (PRF) membrane obtained from patient’s own blood was also placed to enhance soft tissue maturation and healing. The site initially heals in 2 weeks and matures completely in 6-8 weeks.