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Abstract This study included 10 adult patients of both sexes with total number of 20 maxillary sinuses indicated for open sinus floor elevation procedure prior to implant placement. Operative procedures were performed in two stages: First stage surgery: maxillary sinus floor elevation using lateral window approach according to Boyne and James, the space performed after elevation was maintained with a titanium mesh without any grafting material in one side versus PRF grafting material in the other side with using covering membrane in both sides. Second stage surgery: After 6 months ( at the time of implant placement) core biopsy specimens were harvested from the planned implant sites. First stage and the second stage surgeries were performed under local anesthesia. The patients were clinically and radiographically evaluated, The clinical evaluation included assessment of complications during surgery and postoperative healing. Radiographic evaluation involved CBCT radiographs taken for every patient immediate and 6 months postoperatively to evaluate the changes in bone. While histopathological evaluation involved transcortical bone biopsies taken after 6 months during the second stage surgery for implant placement |