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The use of the crestal approach to augment vertical height of the posterior maxilla for dental implant placement is reviewed in this article. The review of the literature documents the success of using a procedure that has minimal complications associated with it when performed correctly. An algorithmic approach is presented to guide surgeons on using the crestal osteotome approach for posterior maxillary augmentation.

The present report is of 3 patients who underwent a new technique for the posterior maxilla. After multiple dental extractions, the segment's alveolar was split to widen it, and the sinus floor was intruded using an osteotome to lengthen the alveolar height and then grafted with a bone morphogenetic protein-2/absorbable allograft without primary wound closure. Implant placement occurred 4 months later, followed by prosthetic restoration.

Purpose The posterior maxilla presents several challenges to the implant dentist. The pneumatization of the maxillary sinus is one such problem. The management of this problem in the most atraumatic way is important for long-term success of implants placed in this region. Materials and Methods Articles presenting different techniques of sinus lift are reviewed and presented. Results Each technique presented has its own advantages; however, selection of technique should be done cautiously based on long-term results. Conclusion This article reviews techniques and presents advantages, disadvantages and success rates where available.

Purpose: This article compares the long-term outcomes of rigid internal fixation with wire fixation. Patients and Methods: In this retrospective study, nine cases of vertical midface augmentation in which rigid fixation was used were compared with 11 cases with wire fixation. One surgeon completed all cases for the rigid fixation group, and another surgeon completed the cases in the wire fixation group. Results: Follow-up was 16 ± 11 months for the rigid fixation group and 20 ±12 months for the wire fixation group. Inferior movement at the anterior portion of the maxilla was 7.0 ± 2.9 mm with rigid fixation and 4.5 ± 3.6 mm with wire fixation (P < .05). Postsurgical superior movement (relapse) was 0.4 ± 0.4 mm with rigid fixation and 2.4 ± 2.4 mm with wire fixation (P < .01). Inferior movement at the posterior maxilla was 3.1 ± 0.2 mm with rigid fixation and 2.8 ± 2.3 mm with wire fixation. Postsurgical superior movement (relapse) was 0.8 ± 0.4 mm with rigid fixation and 0.5 ± 2.3 mm with wire fixation, which was not significantly different. Conclusion: This comparison showed downgrafting of the maxilla using autogenous bone harvested from the iliac crest and rigid internal fixation to be a predictable and stable procedure.