Membrane exposure post GBR: what can be done?

Last Updated September 25, 2019

I did a direct sinus with Novabone putty [synthetic bone substitute] and planned to place implants after 9 months later because there were some fractures in the cortical bone. I have done some intramarrow penetration with placement of Novabone putty and covered with BioMesh membrane. I closed the surgical flap with simple loop and horizontal mattess sutures. During the healing period there was no membrane exposure but then on tenth day I noticed that the sutures were open so removed them. If I pull on the cheek the buccal gingiva moves. I have kept patient on daily cholrhexidine rinses. There were no soft tissue changes and no inflammation. Now what do you recommend I do? Can I put at Collaplug [resorbable collagen] on top of the membrane or should I leave it as it and allow it to heal? There is also a partially impacted #1 [maxillary right third molar; 18] which can be seen in the photograph.

membrane exposure- the distal one is impacted third molarmembrane exposure- the distal one is impacted third molar
membre exposure- the distal one is impacted third molarmembre exposure- the distal one is impacted third molar

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