Various synthetic materials have been used for OAF closures. Use of gold foil and gold plate for the closure of OAFs was reported for the first time by Goldman and Salman, respectively [59, 60]. It is a simplified technique for the closure of oroantral fistulas. The technique consists of elevating the mucoperiosteum to expose the bony margins of the fistula. Then, the opening is covered with an overlapping margin of burnished gold foil.

The mucoperiosteal flaps are sutured across the gold foil without attempting to realize primary closure. Gold foil acts as a bridge for overgrowing sinus mucosa. After 6 weeks, the foil is exfoliated. A disadvantage of this technique is that it is rather costly and the complete closure and healing requires a long period [57].

Aluminum plates were suggested for OAF closures [61]. According to Steiner, 36-gauge pure aluminum plate is used as a protective plate to aid in closure, using the same technique as in the gold procedure. Buccal and palatal tissues are approximated by sutures. Accordingly, the aluminum plate is constantly visible. After several weeks, the aluminum plate is removed from its initial position as a result of formation reparative tissue underneath. In addition to malleability and smoothness features, aluminum is inexpensive.

Tantalum is a highly biocompatible metal. It has been used for closures of OAFs by McClung and Chipps [62]. Along the same lines as the gold technique, tantalum foil is used as a protective plate to aid in closure. The Tantalum foil was removed after 9 weeks. They reported formation of granulation tissue following the closure.

Closure of OAFs by titanium plate with transalveolar wiring fixation was documented [63]. The results revealed good bony and soft tissue healing. Further, the use of two different materials titanium plates and stainless steel wires did not result complication or distaste because of galvanic current.