Implant placement in the atrophic maxilla: Treatment strategies for bone augmentation according to the initial clinical situation

The rehabilitation of atrophic edentulous maxillae with implant-supported prostheses represent a challenge for oral and maxillofacial surgeons, due to the lack of residual bone and unfavorable intermaxillary relationships. Sinus grafting procedures have been proposed in the last 2 decades to overcome this problem, but very frequently this procedure may be insufficient to obtain long-term predictable results. The aim of this presentation is to present rational treatment protocols by presenting a new classification which correlates the type of atrophy and the most suitable surgical option (which include not only sinus grafting procedures but also the reconstruction of the atrophic maxilla by means of autogenous bone grafts and/or maxillary osteotomies) to allow implant placement in a prosthetically driven ideal position. The rationale in choosing among autogenous bone and alloplastic materials will be also discussed in detail.