What are the outcomes of dental implant placement in sites with oroantral communication using different treatment approaches?: a systematic review.

Background: Oroantral fistula is a pathologic condition caused by various procedures including extraction, trauma and implant insertion. To date, various techniques have been suggested for oroantral fistula management. The aim of this review was to evaluate the outcomes of oroantral communication/fistula closure techniques followed by simultaneous or delayed implant placement.

Methods: Based on the search strategy, an electronic search for English-language clinical studies was performed in PubMed, Web of Science, Scopus and Google Scholar from January 2000 until December 2024. All studies with the focus on the outcomes of oroantral communication/fistula closure followed by simultaneous or delayed implant placement were included.

Results: Initial research led to 56 studies. Following removal of duplicates and irrelevant studies, full texts of 20 articles studies. Finally, 15 studies were included in the review. In 3 and 11 studies, implant placement was performed simultaneously or delayed, respectively and one reported both protocols. The largest and smallest diameter of fistula were 20 mm and 4 mm, in order. Different treatment protocols including bone grafting, buccal fat pad and collagen strip technique were performed in included studies. None of the studies mentioned undesirable effects during follow-ups.

Conclusion: All treatment modalities offered acceptable outcomes. However, because of heterogeneity of studies, no standard treatment protocol can yet be suggested. However, influential factors including defect characteristics, patient's medical history and sinus health, location and accessibility must be considered prior to choose the best treatment approach.