Maxillary sinus membrane perforation is the most common complication that occurs with the sinus elevation augmentation procedure. Repair of relatively small (5-10 mm) tears is commonly done using fast resorbing collagen membranes and/or by allowing the sinus membrane to overlap on itself. A technique using a cross-linked type I collagen membrane for predictable repair of large perforations (> 10 mm) as well as for circumstances in which no membrane is found is described. This technique has several advantages because of its inherent biologic properties.