Proximity of maxillary molar teeth roots to the maxillary sinus floor can potentiate oroantral communication (OAC) after extraction. Considering the defect size and situation, surgical treatment may become essential. Surgical treatment modalities are variable and would be indicated in special clinical circumstances.In this article, a chronic case of OAC with a size of 25 × 15 mm in a 30-year old man with history of heavy smoking and drug abuse was treated with combination of buccal fat pad (for covering sinus floor), coronoid process pedicled on temporalis flap, and mucosal closure. There was no complication during and after operation. Short- and long-term follow-up revealed success of this novel technique despite the patient's poor compliance.