Combination with guided bone regeneration

Dr. Joao Batista Césear Neto
Sorocaba, Brazil
Dr. Luiz Antonio Ruy
Sorocaba, Brazil


Clinical Challenge

A difficult case of oral rehabilitation with a particular challenge at regions 15 and 16. The patient had a car accident some years before and was hit in this area. It resulted in an anatomical change to the sinus with partial loss of buccal sinus wall and scar tissue inside part of the sinus.


Clinical outcome at a glance


  • Challenging due to anatomic variations caused by previous car accident.
  • Sinus floor elevation with lateral window approach in combination with a guided bone regeneration.
  • Implant placement at 10 months after bone augmentation.


  • Two-stage sinus floor elevation treatment.
  • A sinus floor elevation in combination with a guided bone regeneration using Geistlich Bio-Oss® and Geistlich Bio-Gide® leads to stable bone volume for implant placement.

Aim / Approach

During flap reflection, the scar tissue was dissected and part of it removed. After this step, a Geistlich Bio-Gide® membrane was placed to isolate the fibrotic tissue present in the superior part of the sinus. Then the sinus membrane was elevated in the medial region of the sinus. The sinus cavity was filled with Geistlich Bio-Oss® which was also used to regenerate the ridge deficiency. Geistlich Bio-Gide® was stabilized buccally with bone tacks and packed in the palate.


This approach was able to regenerate both the sinus and ridge bone deficiency in one surgery.