Background: Oroantral communication (OAC) can occur after a dental extraction. Occasionally, bony defects may persist despite successful soft tissue closure of the OAC. The absence of bone in these areas poses challenges for dental implant placement. This report describes a novel approach of vertical sinus elevation through the oroantral bony defect to address such scenarios. Methods: A 36‐year‐old male (Patient 1) and a 62‐year‐old female (Patient 2) presented with OACs in the first maxillary molar region. Vertical sinus elevation was achieved through the existing defect. This was followed by placement of corticocancellous bone allograft mixed with platelet‐rich fibrin (PRF) in the space surrounded by the elevated sinus membrane that was then covered with a resorbable collagen membrane. Implants were placed 9 and 6 months after the sinus lift in Patient 1 and Patient 2, respectively. Results: In both cases, substantial radiographic bone fill of the oroantral bony defect was achieved allowing successful placement of dental implants. Following insertion of final restorations, the patients were satisfied with the esthetic outcomes and reported improved oral function. Conclusions: Vertical sinus elevation through residual bony oroantral defects in conjunction with placement of bone allograft mixed with PRF yields sufficient alveolar bone for subsequent placement of dental implants. Key points: Elevation of the sinus membrane through an existing crestal defect resulting from an OAC allows the clinician to successfully elevated the sinus membrane for bone augmentation allowing eventual placement of an implant. The approach allows the clinician to achieve this goal without preparing a second window through a more invasive lateral approach. Plain language summary: Bone defects secondary to oroantral communications resulting from dental extractions may persist despite successful soft tissue closure. Such oroantral communication (OAC) pose challenges for dental implant placement. This report describes a technique for repairing oroantral bony defects and subsequent placement of dental implants. Two patients presented with OACs in the first maxillary molar region. Vertical sinus elevation with corticocancellous bone allograft and platelet‐rich fibrin, was achieved through the existing defect. Substantial radiographic bone fill of the oroantral bony defect was achieved and implants with final restorations were subsequently placed.

Background: Over the past two decades, with the collaboration between periodontists and orthodontists, the concept of a surgically facilitated orthodontic therapy (SFOT) approach was developed, which not only provides acceleration in tooth movement as a result of a stimulated regional acceleratory phenomenon but also increases the alveolar bone volume for orthodontic tooth movement range by bone grafting. Despite the benefits, hard and soft tissue defects can sometimes be observed in patients post SFOT, especially among groups with thin periodontal phenotypes. Methods: In the current study, we compared the traditional SFOT with allograft only and the modified SFOT with allograft and collagen matrix to explore if the addition of a collagen matrix between the bone graft and periodontal flap could achieve soft tissue augmentation and reduce the prevalence of the complications of SFOT. Six patients were initially enrolled in the current study. Four patients showed up for the 1-week and 2-week post-operation evaluations. However, only one subject of each group agreed on periodontal evaluation by bone sounding and CBCT during the 6-month follow-up appointment. Results: Six months post SFOT, the patient with the modified SFOT presented with a larger amount of soft tissue thickening compared to the patient with traditional SFOT. However, the location of bone generation was different between groups, with the modified SFOT group presenting with bone generation more apically. In addition, patients with modified SFOT reported a more severe level of discomfort than patients with traditional SFOT. Conclusions: The modified SFOT may potentially improve soft tissue phenotype; however, further modifications are needed to reduce the patient’s discomfort level and to ensure that bone particles are contained more incisally.