Multiple techniques have been described for the closure of OAFs using lyophilized fibrin glue of human origin [53]. In this technique, the fibrin glue is prepared and injected into the socket, together with the collagen sheet. Stajčić et al. stressed the importance of inserting the syringe above the floor of the antrum to protect the clot from airflow [53]. The technique is simple with few postoperative complaints. Importantly, there is no need to raise flaps; hence, the intraoral anatomy remains intact [54]. According to the manufacturer, the major disadvantages of the procedure are the risk of transmitting viral hepatitis and the preparation time required for the fibrin glue [53].

The use of lyophilized dura for closure of OAF was reported by Kinner and Frenkel [55]. In this technique, the sterilized dura is placed in a saline solution to regain its pliability. Thereafter, it is cut to size to make it cover the bony margins of the defect. Sutures are placed at each corner of the graft and then it is covered with a plastic plate for protection. The dura is exfoliated after 2 weeks. The simplicity of the technique and non-surgical approach make it an attractive option for OAF closures. However, the risk of transmitting pathogens is a main disadvantage.

Lyophilized porcine dermis for closure of OAFs has been described in the literature [56, 57]. The technique reported good results when the porcine graft was either exposed to the oral environment or covered with buccal and palatal sliding flaps [56, 57]. According to Mitchell and Lamb covering the graft by buccal and palatal flaps is not necessary [56]. The main advantage of the collagen is potential incorporation into the granulation tissue, and thus, no need to remove it prior to complete healing [56].

Ogunsalu achieved both bony (hard tissue) and soft tissue using Bio-Gide® (porcine collagen membrane) (Geistlich Biomaterials, Wolhusen, Switzerland) and Bio-Oss® (non-sintered bovine bone materials) (Geistlich Biomaterials, Wolhusen, Switzerland) to close OAFs [58]. In this technique, the Bio-Oss® granules were sandwiched between two sheaths of a Bio-Gide® membrane for the hard tissue closure of oroantral defect. Thereafter, a full-thickness mucoperiosteal flap was raised and the Bio-Oss®–Bio-Gide® sandwich placed underneath. Then, the flap was repositioned, resulting in primary closure. There was an excellent bony regeneration which allowed placement of an endosseous implant. Radiographically, bony healing of the defect was observed after 8 months. The technique offers the unique advantage that no donor site surgery is necessary. The disadvantage in this technique is the need for a mucoperiosteal flap to cover the sandwich.