Recently, auricular cartilage graft has been used for the closure of OAFs. A full-thickness flap is raised at the defect site [47]. A semicircular incision is then made posteriorly over the conchal cartilage. The conchal cartilage with overlying perichondrium is exposed with a blunt dissection. The harvested auricular graft is then adapted on the defect site and sutured with the surrounding tissue. The mucoperiosteal flap is then advanced and sutured with the palatal tissue. The technique is biocompatible, highly resistant to infection, and easy to harvest. Additionally, it does not require vascularization for the integration to the recipient site. Consequently, there is a decrease in the failure rate of the graft [47]. A disadvantage of this procedure is the potential formation of a defect at the donor site.

The use of septal cartilage especially for larger oroantral fistulas was documented [48]. A buccal mucoperichondrial flap is raised, generally starting two teeth mesial and ending, and if feasible, one tooth distal to the site of the fistula. An incision is performed at the caudal end of the septal cartilage, and a mucoperichondrial flap is raised on one side. A cartilage island is outlined and dissected free. The cartilage is trimmed and insinuated into defect as a horizontal plate [48]. Saleh et al. obtained a success rate of 95.7% in their study using septal cartilage [48].

According to Aladag et al., the modified Caldwell-Luc Approach is a satisfactory method to close oroantral defects [49]. In the technique, which includes endoscopic examination using the Caldwell-Luc approach, the inside of the maxillary sinus is explored fully. The bone graft can be harvested from the bone of the anterior wall of the maxillary sinus by accessing the surgical entry tract. The positive features of the technique include the use of autogenous grafts, easy and adequate harvesting of the graft along the surgical route, and no need for a flap. Among its disadvantages are the fact that it requires endoscopic surgical equipment and experience.