Different curettes may be used to facilitate elevation. Tidal respiratory movements will allow assessing integrity of membrane. Medial extension to nasal aspect would ensure adequate elevation, and room for augmentation. The graft material is placed in the sinus and condensed using a periosteal elevator, or Q-Tip. Special delivery syringes may also be used.
Some clinicians add tetracycline to the graft.
No membrane is necessary for coverage of the graft. Primary closure using interrupted sutures is recommended. Posterior maxilla, symphysis, posterior mandible, or iliac crest serve as good autogenous donor sites. Bioactive glass, hydroxyapatite, freeze-dried bovine bone are being frequently used for augmentation. Followed by doxycycline x 1-2 weeks.