Restoratively driven planning for implants in the posterior maxilla - Part 1: alveolar bone healing, bone assessment and clinical classifications

Sinus augmentation in conjunction with implant placement is widely considered to be a predictable and successful treatment option for the edentulous posterior maxilla. However, the anatomical changes of the posterior maxilla following tooth extraction (namely alveolar atrophy and pneumatisation of the maxillary sinus) creates unique challenges for implant and prosthodontic rehabilitation. A large volume of literature has been published regarding the surgical indications and treatment planning for implants in the posterior maxilla. In comparison, there is a relative paucity of literature regarding the prosthodontic challenges associated with implants placed in augmented maxillary sinuses. This article describes the scientific background of native and grafted alveolar bone healing in relation to implant rehabilitation. Furthermore, clinical classifications available to assist implant treatment planning are described.