Closure of oroantral communications using biodegradable polyurethane foam: a long term study in rabbits

An oroantral communication (OAC) is an open connection between the oral cavity and maxillary sinus. Closure of OACs is commonly performed with a surgical procedure using a mucoperiosteal flap. An alternative technique using synthetic biodegradable polyurethane (PU) foam for closure of OACs is presented. This PU foam is composed of hard urethane segments, and soft segments made of D/L lactide (50/50), epsilon-caprolactone, and 5% polyethyleneglycol (PEG). To evaluate the use of PU foam for this application, OACs were created in the edentulous part of the maxilla in 21 rabbits, after which PU foams were fitted in the defects. Results showed complete healing of the oral mucosa after 4-10 weeks, healing of the antral mucosal lining after 6 months and complete bony regeneration after 1 year. No reopening of the defects occurred and no maxillary sinusitis was observed. Degradation of the PU foam had not yet reached completion 1 year after implantation. In conclusion, PU foam with 5% PEG provides adequate closure of an OAC in the rabbit model to support healing of the oral and maxillary sinus mucosa. Longer time intervals are needed to assess the complete degradation of the PU foam.