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The increasing use of osseointegrated implants requires special attention to overcome limitations in bone tissue. In maxillary posterior region, sinus pneumatization reduces bone availability for implants insertion. Membrane perforation is commonly observed during sinus lift procedure, when trying to achieve bone volume. Through a case where the implant was removed from inside the maxillary sinus patient, causing extreme membrane and bone damage. An alternative treatment using the periosteum as membrane is described.&nbsp