AutoresLevi Cuadrado-González, Antonio Jiménez-Garrudo, Aritza Brizuela‐Velasco, Esteban Pérez-Pevida, David Chávarri‐Prado, Markel Diéguez-Pereira, José María Pacho-Martínez
Maxillary sinus elevation procedures are widely used in oral surgery and implant dentistry in those cases with insufficient bone height resulting from bone atrophy and pneumatized maxillary sinuses, which precludes dental implant insertion.1Sinus augmentation therapy generates sufficient bone height to enable the placement of posterior maxillary implants and, since its introduction by Boyne and James,2 has proved a highly predictable procedure.The most common complication involved in sinus elevation augmentation is membrane perforation. The incidence of this event ranges from 10%–56%.3The use of collagen membranes for sealing sinus perforations has been shown to be a predictable method for managing these complications.4 The classic mode uses a resorbable collagen membrane as a new wall, enabling accurate placement of the regeneration material and avoiding the displacement of the graft particles into the sinus cavity.5In this context, we planned to devise a modification to the Loma Linda pouch technique described by Proussaefs and Lozada.3 This “hammock” approach immobilizes the collagen membrane as far as possible, promotes greater blood supply, thereby increasing vital bone formation.When perforation occurs during elevation of the Schneiderian membrane, elevation of the membrane from the internal sinus walls must be completed (Figure 1).Once the final regenerating cavity has been prepared, 2 horizontal perforations are made, using a lance-shaped drill bur, through the palatal mucosa reaching the palatal sinus wall surpassing it up to the cavity. These perforations must be made over the height required for placing the future dental implants. Afterwards, the 2 corresponding horizontal perforations are made in the buccal sinus wall above the lateral window created for sinus lift procedure (Figures 2 and 3).A resorbable collagen membrane is prepared (Jason; Botiss Biomaterials, Zossen, Germany) by making 2 perforations at its narrowest side with a nonresorbable 4/0 she
