Management of Atrophic Posterior Maxilla

Course Faculty
Homa H. Zadeh, DDS, PhD
Stephen S. Wallace, DDS
Pascal Valentini, DDS

Course Description

The atrophic posterior maxilla has unique anatomic and structural features, including proximity to the maxillary sinus and low-density bone. The atrophic ridge can either be managed through regenerative or non-regenerative approaches. Sinus augmentation and alveolar ridge augmentation are examples of regenerative therapies. Several factors have to be considered in order to decide whether sinus or ridge augmentation or both should be employed for optimal bone volume and contour. These include:

  1. Full vs partially-edentulous patient
  2. Position of the edentulous alveolar crest relative to the bone level on adjacent teeth
  3. Esthetic requirement.

Flap management in the posterior maxilla requires specific considerations and provides unique opportunities to protect the graft and at some point, to augment the mucosa and extend the vestibule. Implant therapy in this region may also be managed through non-regenerative approaches, such as application of short or tilted implants. This course provides a comprehensive approach for managing patients with atrophic posterior maxilla.


Educational Objectives

Classification of Alveolar Ridge Deficiencies
Risk Assessment:

  • Patient and site characteristics
  • Management of patient/site risks

Material Selection:

  • Autogenous: methods & location of harvesting
  • Xenograft: is sintering temperature important?
  • Alloplast: HA, TCP, biphasic
  • Allograft (Processing)
  • Platelet Rich Fibrin (PRF):
    • Biology
    • Protocol
    • Applications
    • Forms: liquid PRF, solid matrix PRF
  • Membrane selection:
    • Resorbable vs non-resorbable
    • Cross-linked vs native collagen
  • Fixation system:
    • MODfix/UNIfix
    • Tenting screws
    • Membrane fixation


  • Lateral sinus augmentation
  • Antrostomy design
    • Instrumentation and devices
    • Piezosurgery
    • Rotary instruments
  • Transcrestal sinus augmentation
    • Technique and instrumentation

Flap design:

  • Flap design for GBR and sinus augmentation
  • Achieving tension-free flap
  • Management of failed sites with scarred periosteum

Suture material & techniques:

  • Prevention of graft exposure

Graft and membrane stabilization
Soft tissue management:

  • Timing and staging: before or after GBR
  • Material:
    • Native xenogenic Collagen (Mucograft)
    • Form-stable xenogenic Collagen (FibroGide)
    • Connective tissue graft
    • Free gingival graft
  • Vestibuloplasty
    • FIVE (Fibrin Immobilization Vestibular Extension)


  • Prevention and management

Pre- and Post-Operative Care:

  • Antibiotics and antiseptics
  • Analgesics
  • Anti-inflammatory agents
  • Nutritional and herbal supplements


Hands-On Workshop Simulated Exercises

  • Flap Design:
    • GBR in posterior maxilla
    • Flap design for lateral window antrostomy
    • Flap design for crestal osteotomy
  • Piezosurgery
  • Platelet Rich Fibrin (PRF):
    • Preparation
    • Liquid PRF, solid matrix PRF
  • Membrane Fixation
  • Fixation System:
    • MODfix UNIfix
    • Tenting screws
    • Membrane fixation
  • Lateral vs transcrestal sinus augmentation
  • Sinus antrostomy design
  • Suture techniques: to prevent graft exposure
  • Graft and membrane stabilization
  • Decortication
  • Soft tissue management
  • Vestibuloplasty


Live Surgery Demo

  • Lateral window sinus augmentation
  • GBR: posterior maxilla
  • Platelet Rich Fibrin (PRF):
    • Preparation
    • Liquid PRF, solid matrix PRF


Educational Format

This course offers flexible educational format to accommodate all clinicians’ needs and interests. Participation may take place either:

  • Lecture only or lecture plus hands-on workshops (items will be shipped to participants)

Regardless of mode of participation, online resources are available to supplement live lecture material. This information is accessible on an on-demand basis.



$1495 Remote Learning: Lecture + Workshop
$995 Remote Learning: Lectures Only

Tuition for remote workshops includes two-way shipment of all supplies to allow participants to complete the workshops in their own facility.


CE Units

16 hours of on-demand content (includes: lecture, hands-on workshop, and live surgery demonstration)

Course Brochure