Platelet ‐ Rich Fibrin in the Management of Oro‐Antral Communications and Fistulas: A Systematic Review of Systematic Reviews

Background Oroantral communication (OAC) and fistulas (OAF) are pathological openings between the maxillary sinus and the oral cavity. Traditional closure methods, such as buccal or palatal flaps, are effective but can cause postoperative discomfort and tissue loss. Platelet‐Rich Fibrin (PRF), has emerged as a minimally invasive alternative, promoting angiogenesis and tissue healing through the sustained release of growth factors. This study aimed to review the current evidence on the effectiveness of Platelet Rich Fibrin in the management of oroantral communications and oroantral fistulas. Methods A study protocol was developed in accordance with the Preferred Reporting Guideline for Overviews of Reviews (PRIOR) and registered on the International Prospective Register of Systematic Reviews (PROSPERO) under Registration No. CRD 420251027772. Furthermore, the reporting of the present systematic review was performed based on the PRISMA checklist. Results Our search strategy yielded 220 articles from five electronic databases. Of these, 82 were duplicate studies, leaving 138 unique records, which were screened independently by two authors for eligibility. 120 studies were excluded based on title and abstract screening. The remaining 18 full‐text articles were assessed for eligibility. 15 studies were excluded as they did not meet the inclusion criteria. Finally, a total of three systematic reviews met the criteria for inclusion and were critically reviewed. Conclusions This systematic review of systematic reviews highlights the consistent effectiveness of platelet‐rich fibrin (PRF) in the closure of oroantral communications and fistulas, with reported success rates between 90% and 100%. PRF enhanced healing, reduced complications, and improved patient comfort, particularly when used as an adjunct to surgical flaps in larger defects. PRF appears to be a reliable and biologically advantageous material; nevertheless higher‐level studies are needed to confirm its comparative effectiveness and guide clinical protocols.