Bilateral sinus floor elevation

1. Initial panoramic X-ray, showing pneumatization of both maxillary sinuses

2. Initial intra-oral situation

3. Full thickness mucoperiosteal flap with mesial release incision, to access the right maxillary sinus

4. Opening of lateral window with a high speed bur

5. Raising of the Schneiderian membrane creating the space for the graft

6. OsteoBiol® Evolution membrane protecting the ceiling of the sinus

7. Beginning filling the lifted sinus with OsteoBiol® Putty

8. Finishing the filling of the sinus with OsteoBiol® Putty

9. Protecting the xenograft with OsteoBiol® Evolution

10. Suture of the flap with polyamide 4(0) suture with simple stitches

11. Full thickness mucoperiosteal flap with mesial release incision, to access the left maxillary sinus

12. Opening of lateral window with a high speed bur

13. Raising of the Schneiderian membrane of the sinus, creating the space for the graft

14. Beginning filling the lifted sinus with OsteoBiol® mp3®

15. Finishing the filling of the sinus

16. Protecting the xenograft with OsteoBiol® Evolution

17. Suture of the flap with polyamide 4(0) suture with simple stitches

18. Four dental implants (2 in each sinus) were placed after 8 months of healing. Rehabilitation with fixed ceramic bridges after 3 months

19. Final fixed oral rehabilitation with bridges over implants in the posterior regions and ceramic crows on the anterior teeth (occlusal view)

20. Patient smile after the rehabilitation

21. Panoramic final X-ray at 5-year follow up