Complications of Sinus Grafting and the Atrophic Maxilla

Occlusal rehabilitation of the atrophic maxilla with dental implants poses a great challenge to both the surgeon and the prosthodontist. Disuse atrophy of the alveolar ridge might impede straight forward implantation, specifically in posterior maxilla where the quality of bone is of concern as well. Sinus grafting has been the go-to technique for placing dental implants in posterior maxilla when sinus pneumatization reduces the available alveolar bone height after tooth extraction. Also the advent of Zygomatic, pterygoid, trans-sinus, and ultrashort implants has enabled clinicians to entertain the possibility of immediate loading in edentulous maxilla as well as eliminating the need for grafting procedures. In the case of a severely atrophied maxilla and midface, bone augmentation using autogenous onlay and interpositional grafts might be the only solution if using zygomatic implants are hindered. Despite the significant success attained with the above mentioned techniques, each might lead to complications which the clinician should foresee and be prepared for.