Placing implants in the posterior of the upper jaw can be a problem if bone loss there is severe or the sinus has expanded too much in the bone space. The lack of bone volume can be overcome with a bone graft in the lower part of the sinus by an access opening through the lateral wall.
The implants are usually placed four to six months after the sinus graft. The graft itself is replaced by the patient’s own bone cells and the resulting healed graft is dense and strong. Dr. Hilt Tatum originated this graft technique in 1975. See below for the x-rays of one of Dr. Ruff's cases.