Comparison of the Buccal Periosteal Inversion Flap and Buccal Advancement Flap for the Closure of Acute Oro-Antral Communications: A Prospective Randomized Controlled Clinical Trial
Sponsor study identifier
interventional
22
1 country
1
Study Start
October 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Primary Completion
December 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
March 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
This prospective randomized controlled clinical trial will compare the Buccal Periosteal Inversion Flap (BUPI) with the Buccal Advancement Flap (BAF) for the primary surgical closure of acute oro-antral communications (OAC) following tooth extraction in the posterior maxilla. The primary objective is to determine whether the BUPI technique results in better preservation of keratinized gingival width compared with the BAF technique three months after surgery. Secondary outcomes include successful closure rate of OACs, postoperative pain, swelling and bleeding, wound dehiscence or recurrence of the OAC, postoperative sinusitis or infection, reoperation rate, and operating time. Participants will be randomly allocated in a 1:1 ratio to either BUPI or BAF. Clinical examinations and intraoral scans will be performed before surgery and at follow-up visits after 14 days, one month, and three months.
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
March 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
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Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
October 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
October 13, 2026
Actual (reported)October 20, 2026
Actual (reported)December 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
March 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Change in Width of Keratinized Gingiva
Change in keratinized gingival width in millimeters between the preoperative baseline assessment and the three-month postoperative assessment. Keratinized gingival width will be measured between the mucogingival junction and the midpoint of the alveolar ridge using digital intraoral scans obtained with a 3Shape TRIOS 6 intraoral scanner and analyzed using 3D Slicer software.
Baseline to 3 months after surgery
Successful Closure of the Oro-Antral Communication
14 days after surgery
Postoperative Pain
Day 0 through postoperative day 7
Participants assigned to this group will undergo surgical closure of the acute oro-antral communication using the Buccal Periosteal Inversion Flap.
Participants assigned to this group will undergo surgical closure of the acute oro-antral communication using the Buccal Advancement Flap.
Following elevation of a trapezoidal buccal mucoperiosteal flap, the periosteum is dissected from the overlying buccal mucosa from apical to coronal. The mobilized periosteal layer is inverted over the oro-antral communication and sutured to the palatal soft tissue to achieve tension-free closure, while the overlying buccal mucosa is largely maintained in its original position.
Medical University of Graz, Department of Dental Medicine and Oral Health
Graz, Styria, 8043, Austria
Reddy GA, Neelima C, Reddy GS, Charan DG, Samavedam SP. Buccal periosteal inversion flap technique after tooth extraction versus healing by secondary intention for preservation of keratinized gingiva and alveolar ridge: A comparative study. J Maxillofac Oral Surg. April 2025.
Raj G, Raj M, Loh JSP. Pathophysiology and clinical presentation of odontogenic maxillary sinusitis. Dentistry Review. June 2022;2(2):100044.
Cezairli B, Taskesen F, Yilmaz Altintas N. Causes and treatments of oroantral communications: Experience with 103 cases. Ann Med Res. 2021;28(1):204-209.
Rosenfeld EA. Inverted periosteal flap: an alternative to the buccal advancement flap for tension-free, watertight closure. J Oral Maxillofac Surg. 2014 Jul;72(7):1244-50. doi: 10.1016/j.joms.2014.03.006. Epub 2014 Mar 20.
Barbara Kirnbauer, PD DDr.
Medical University of Graz
Norbert Jakse, Prof. DDr.
Medical University of Graz
First Submitted
October 13, 2026
First Posted
October 20, 2026
Study Start
October 2026
Estimated (date passed)This estimate has passed. The registry has not confirmed an actual date for this milestone.
Postoperative Swelling
Day 0 through postoperative day 7
Postoperative bleeding
Day 0 through postoperative day 7
Number of Participants with Postoperative Wound dehiscence
14 days after surgery
Following elevation of a trapezoidal buccal mucoperiosteal flap, the periosteum is incised to allow mobilization of the flap. The entire mucoperiosteal flap is advanced over the oro-antral communication to the palatal soft tissue to achieve tension-free primary closure.
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Balicz A, Szurko A, Jedzierowska M, Kielbon A, Wojcik S, Adamczyk J, Starosta M, Fiegler-Rudol J, Morawiec T. Acute Oroantral Communication Closure: Resorbable Collagen Membrane vs. Buccal Advancement Flap Outcomes: A Clinical Trial. J Funct Biomater. 2026 Mar 18;17(3):150. doi: 10.3390/jfb17030150.
Primary Completion
December 2027
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
March 2028
EstimatedPlanned date reported by the registry; this milestone is not confirmed as achieved.
Last Updated
October 23, 2026
Record last verified: 2026-09
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