Figure 1. Failing dentition on the right posterior maxilla. Figure 2. Esthetically and functionally demanding severe vertical defect. Figure 3. Deficient alveloar ridge revealed following full-thickness flap elevation. Figure 4. Sinus proximity managed with combined sinus floor elevation procedure.

Figure 5. Equal volumes of particulate autogenous bone with an anorganic bone mineral, combined with recombinant human platelet-derived growth factor, are applied to defect. Figure 6. The membrane is secured over the graft with titanium pins. Figure 7. The residual defect between the applied titanium reinforced expanded polytetrafluoroethylene membrane is filled with additional graft material. Figure 8. The treatment area and the sinus window are protected with a resorbable collagen membrane.

Figure 9. Following 9 months of uneventful healing, the expanded polytetrafluoroethylene membrane (e-PTFE) membrane has maintained its position with excellent bone regeneration between the distal surface of the previously denuded tooth No. 4 and the titanium reinforced e-PTFE membrane. Figure 10. Clinical view of the regenerated alveolar crest. Figure 11. Occlusal view of 3 implants placed into ideal positions. Figure 12. The final reconstruction demonstrates a functional and esthetic outcome. Figure 13. Stable crestal bone around the implants and regenerated bone in close apposition with previously denuded tooth No. 4.