Elevation with large sinus membrane perforation

Assoc. Prof. Prisana Pripatnanont
Hatyai, Thailand


Clinical Challenge

In this case a long term follow-up of a sinus floor augmentation was carried out. A large Schneiderian  membrane perforation was repaired using Geistlich Bio-Gide® and platelet-rich fibrin (PRF), and a sinus floor grafting was performed with Geistlich Bio-Oss® particles. A 61-year old woman came to the dental office and asked for an implant-supported prosthesis in the area of the left 2nd premolar and 1st molar. The edentulous area had a bone height of 4-5 mm. A sinus floor elevation was planned followed after 7 months by implant placement. During the opening of the lateral window to the sinus floor, a Schneiderian membrane perforation occurred caused by the rotary bur due to a very thin Schneiderian membrane. In order to repair the complete perforation site Geistlich Bio-Gide® and PRF were used to cover the perforation. Afterwards the sinus floor was elevated with 1 g of Geistlich Bio-Oss® particles. The implant had been placed 7 months after augmentation with a good primary stability. Prosthesis construction was done 4 months after implant placement. After a 2-year follow-up period, the implant showed no marginal bone resorption, the bone grafting area showed minimal volume change and good support to the implants.


Clinical outcome at a glance


  • Sinus floor elevation using Geistlich Bio-Oss® and Geistlich Bio-Gide®.
  • Repairing a large Schneiderian membrane perforation with Geistlich Bio-Gide®.


  • Two-stage sinus floor elevation treatment.
  • Effective bone support and stable bone volume by using Geistlich Bio-Oss®.
  • Effective application of a Geistlich Bio-Gide® in a large Schneiderian membrane perforation.

Aim / Approach

To demonstrate the efficiency of Geistlich Bio-Gide® for repairing a large Schneiderian membrane perforationand good long term stability of Geistlich Bio-Oss® granules in sinusgraft procedures showed minimal volume change.


Geistlich Bio-Gide® is effectively used for repairing major sinus membrane perforation and sinus  augmentation with Geistlich Bio-Oss® granules is effective in bone support and stable volume.