الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Implant rehabilitation of posterior maxillary region offers a great challenges because of bone resorption in an apical direction after extraction , continuous pnumatization of the sinus through out life in a coronal position and the nature of the low bone density in that region , which affect bone quality and quantity and jeopardise the primary stability needed for the success of the implant . So , in order to increase the bone quality and quantity of the posterior maxilla , different augmentation procedures with sinus floor elevation were developed . The most common techniques used especially in the severe vertical defects with < 5mm residual bone height recommended 2 staged procedure in which the sinus floor is elevated and augmented with bone graft in the first stage and then inserting the dental implant in a seconed stage because of the remaining residual bone height can’t provide the primary implant stability, which elongates the rehabilitation procedure for up to one year and increases the surgical interventions . Therefore , a technique provides augmentation with sinus floor elevation and stability of inserted implant all in one stage was needed especially in the severe vertical defects. For this purpose, this study was carried out on 10 adult patients wanted to restore their posterior maxillary teeth with < 5mm residual bone height under the maxillary sinus . patients were collected from Department of Oral and Maxillofacial Surgery Faculty of Dentistry Tanta University . Osteotomy was made transcrestally at the recipient site with a triphine bur leaving 1mm from the floor of the sinus. Then, the bony island was fractured towareds the sinus with freeing of the membrane . We harvested a corticocancellous bone block containing the implant from the chin bone and put it press-fitted in the recipient site osteotomy . The patient were followed up : • Clinically : after 1,2 weeks and 1,2,3 and 6 months to evaluate the success of the surgery , pain , signs of infection , wound dehiscence , sinusitis and finally the stability of implant by osstell device after 6 month. • Radiographically : was performed by CBCT 6 month postoperative to evaluate the implant and the grafted bone height , width and density . Successful sinus floor elevation and press-fitted graft containing the implant harvested from the chin in all ten patients with no signs of infection , wound dehiscence , sinusitis and with good clinical stability after 6 months . only one case ( case no. 3 ) had wound dehiscence after 3 weeks over small part of the graft which is removed under local anesthesia and healed with secondary intention after the second month without any harmful effect on the final result . Radiographical evaluation was performed by CBCT 6 months postoperative in comparison to the perioperative CBCT to the recipient and the donor site showing successful implant osseointegration , significant increase in bone density , significant increase in bone height and no significant changes in bone width.