The use of Titanium Meshes in Surgical Closure of the Oroantral Fistula. A Randomized Clinical Trial Study

The closure of oroantral communications (OACs) is challenging. The study aimed to assess the effect of titanium meshes in the outcome of OAC closure by local flaps. This is a prospective randomized, nonblinded clinical trial. Patients with a delay and large (≥7 mm 2 ) OAC were studied. Patients were randomly divided into 2 groups: in group 1, patients underwent OAC closure through a modified Rehrmann buccal advancement flap with a titanium mesh, and in group 2, the modified Rehrmann buccal advancement flap. The primary predictive factor was the use of titanium mesh. Dehiscence (the breakdown of the edge of flaps without the complete reopening of the defect) was a primary outcome. The defect's reopening was considered a secondary outcome. Nineteen patients in group 1 and 20 in group 2 were studied. In 2 months after treatments, the prevalence of dehiscence in group 1 was 3, and 10 patients in group 2 ( P =0.041). In group 1, patients did not show OAC exposure. However, OAC exposure was observed in 2 patients in group 2. This study demonstrates that using titanium mesh in combination with a modified Rehman flap decreases the prevalence of dehiscence compared with a flap alone.