OBJECTIVE: To assess the clinical capacity of a bioabsorbable root analog to close oroantral perforations after extraction. STUDY DESIGN: In this prospective case-cohort study, 20 consecutive patients with oroantral communications greater than 2 mm were treated with a bioabsorbable root analog (RootReplica). Patients were followed up clinically and radiographically for 3 months to monitor the healing process. RESULTS: Root replicas could be placed in 14 patients, whereas 6 patients required the socket to be covered with a buccal sliding flap. In the latter cases, fragmentary roots or overly large defects prohibited replica fabrication or accurate fitting of the analog, respectively. Healing was uneventful in all patients, and epistaxis, swelling, or pain was observed only in patients treated with flaps. CONCLUSIONS: The method described is a valuable alternative method with which to close oroantral communications but cannot be performed in all patients because of technical limitations.