Posterior quadrant of the maxilla consider as special challenges for use of implant active prostheses to restore dental function. Placement of Implant in the posterior part of maxilla influence hesitation due to the lack of sufficient alveolar bone height. This occurs due to the proximity of alveolar crest to the maxillary sinus because of sinus pneumatization, along with resorption of bone of the alveolar ridge secondary to tooth extraction, pathological lesion or trauma. Sinus lifting to augment atrophic maxillary posterior area to create space for implantation has been progressively widespread in latest years. In literatures 2 approaches have been designated for sinus lifting: the direct approach called also lateral approach and the indirect approach called also crestal approach.
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