Course:

When assessing a potential future implant site, if the implant does not ‘‘fit’’ due to a deficiency of hard or soft tissue, then to bone, tissue, or sinus grafts the clinician and patient must commit in order to augment that implant site. The posterior maxilla poses several challenges for the placement of dental implants. Bone and tissue loss from periodontal disease, post-extraction bone atrophy in height and width, pneumatization of the maxillary sinuses, poor bone density, and very high occlusal forces are some factors leading to this difficulty. Bone grafting in the maxillary sinus is the solution to obtain adequate bone volume for implant placement. The lateral sinus window technique has been the traditional method of choice to augment the sinus in patients presenting with a severely atrophied posterior maxilla. The crestal approach is generally considered to be a far less invasive procedure with less complications, less postoperative pain, and less swelling for patients. The osseodensified crestal sinus window technique is a safe and effective procedure that produces an increase in bone height comparable to that obtained with traditional lateral window procedures. This innovative technique may provide a viable alternative to the rationale for the lateral window approach.