Buccal pad of fat, advanced platelet-rich fibrin, fibrin glue, and oxidized cellulose plug in the management of oroantral communication: A comparative clinical study

Abstract

Oroantral communication (OAC) is a significant complication following the removal of maxillary posterior teeth that is a consequence of them being close to the maxillary sinus floor. The current study evaluated the efficacy of four treatment modalities for OAC management: buccal fat pads (BFPs), advanced platelet-rich fibrin (A-PRF), fibrin glue, and oxidized regenerated cellulose plugs. Twenty-four patients with OAC were randomly assigned to four treatment groups (n = 6 each) and clinically assessed for facial swelling, healing outcomes, and patient-reported pain at baseline, on day 3, and at weekly intervals for 4 weeks after their respective treatments. A linear mixed-effects model found a significant reduction in pain over time in all groups. Intergroup and intragroup comparisons of postoperative pain showed statistically significant differences between the groups at baseline and after 1 week. The BFP group had the highest scores for initial pain, while the A-PRF group had the least, with a consistent reduction throughout the study. The BFP group displayed significantly increased facial swelling on day 3, which had subsided after 2 weeks; the fibrin glue group followed a similar pattern but stabilized quickly. The A-PRF group showed minimal swelling and rapid tissue regeneration, while the oxidized regenerated cellulose group displayed less responsiveness for larger OACs. The choice of therapeutic technique for managing OACs should therefore be chosen according to the defect size and anatomical considerations. While BFP and fibrin glue were more efficacious for larger defects, the A-PRF technique showed rapid healing and less discomfort.