Bicortical stability of implants placed in severely atrophic posterior maxilla: A case report

Maxillary sinus lift is a common procedure to achieve adequate alveolar bone height in patients with sinus hyper-pneumatization. Simultaneous implant placement with sinus floor augmentations is possible when appropriate primary stability could be achieved. In severe atrophic posterior maxillary ridge, vertical bone height is sometimes less than 4mm, which may hinder simultaneous implant placements and necessitate two stage procedure. In current study, a novel technique is described to perform a single stage implant placement with bicortical stability in severe atrophic maxilla that can shorten the treatment time of an edentulous patient. During the procedure, to achieve an adequate access a conventional lateral window osteotomy is performed. After elevating the Schneiderian membrane using conventional instruments, an autologous ramus block is harvested from the mandible and then the block will be fixed in correct location in the sinus using screws with appropriate length to build sufficient stability as superior cortex for simultaneous implant insertion.