Background: Oroantral fistulas are challenging complications that often require surgical intervention for successful closure and long-term healing.
Purpose: To present a modified submucosal connective tissue flap technique that enhances closure stability and healing predictability in oroantral fistulas.
Methods: Following excision of the fistula and sinus debridement, a standard buccal advancement flap was elevated. A subepithelial connective tissue graft was harvested from the palatal mucosa using a partial-thickness dissection and stabilized using resorbable sutures anchored to bone perforations. The overlying buccal flap was then advanced and sutured to complete a bilayered closure.
Results: The technique allowed tension-free closure with improved flap stability and reduced donorsite morbidity. Postoperative healing was uneventful, and complete mucosal regeneration was observed within one month.
Conclusions: This bilayered closure technique, combining mechanical anchorage of a palatal graft with a buccal advancement flap, provides a reliable and predictable solution for oroantral fistula closure, particularly in edentulous or anatomically compromised cases.
Keywords: Connective tissue flap; Maxillary sinüs; Oroantral fistula; Palatal flap.
© The Association of Oral and Maxillofacial Surgeons of India 2025.