Brisk, prolonged pulsatile hemorrhage during the sinus graft procedure: a case report with discussion on intra-operative hemostatic management.

The maxillary sinus graft procedure is the treatment of choice to increase the vertical bone height in the atrophic posterior maxilla to place dental implants. It is considered as a routine surgical procedure with predictable results. However, complications have been reported with this grafting procedure. With any surgical procedure, complications may arise, and the surgeon must be prepared to effectively manage the complication. In addition to detailed knowledge of the maxillofacial anatomy, recognition of surgical emergencies and its management is critical for the implant surgeon. A case of brisk, prolonged pulsatile hemorrhage during the sinus graft procedure is described, and its intra-operative management with topical Thrombin is presented.