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    • Transcrestal Sinus Floor Elevation

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    • 1. Pre-operative X-ray, showing 2.5 mm residual bone height and the presence of an Underwood septum
    • 2. After raising a minimally invasive full thickness flap, the crestal access was performed mesially to the septum
    • 3. Maxillary sinus floor was interrupted, showing intact Schneiderian membrane
    • 4. One gram of OsteoBiol<sup>®</sup> Gen-Os<sup>®</sup> was mixed with autologous i-PRF
    • 5. Sinus was grafted by condensing gradual increments of xenogeneic granules with osteotomes, until a minimum height of 10 mm was obtained (comprising the residual bone crest)
    • 6. CBCT scan taken one week after surgery shows good contact of the grafting material with lateral and medial sinus walls. Schneiderian membrane is hypertrophic due to the surgical trauma
    • 7. CBCT scan taken one week after surgery shows good contact of the grafting material with lateral and medial sinus walls. Schneiderian membrane is hypertrophic due to the surgical trauma
    • 8. CBCT scan taken one week after surgery shows good contact of the grafting material with lateral and medial sinus walls. Schneiderian membrane is hypertrophic due to the surgical trauma
    • 9. CBCT scan taken six months after surgery. Schneiderian membrane appears healthy
    • 10. CBCT scan taken six months after surgery. Schneiderian membrane appears healthy
    • 11. CBCT scan taken six months after surgery. Schneiderian membrane appears healthy
    • 12. Bone-core biopsy of the grafted area was harvested by using 3mm diameter trephine drill
    • 13. A dental implant (4.0x10mm) was inserted in the biopsy site
    • 14. A dental implant (4.0x10mm) was inserted in the biopsy site
    • 15. Residual biomaterial particles appeared surrounded and joined together by newly-formed bone (magnification 200×). Toluidine blue and pironine G stain (courtesy Prof. Tonino Traini). Histomorphometric analysis showed 25.4% newly-formed bone, 19.9% residual graft particles and 54.7% marrow spaces
    • 16. Detail of Fig. 11: an active site of bone formation, as indicated by the presence of an osteoid rim, is represented at higher magnification (1000× - courtesy Prof. Tonino Traini)
    • 17. Three-year post loading follow up X-ray, demonstrating marginal bone stability and maturation of the grafted area
    • Clinical indication: crestal access sinus lift
    • Products : Gen-Os®
    • Authors : Dr. Claudio Stacchi
    • Information about patient: Female, 66 years old
    • Credits : Documentation provided by Dr. Claudio Stacchi, Gorizia, Italy
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