Sinus floor elevation is the most commonly used method for vertical bone augmentation in the maxillary posterior area. This clinical report describes a modified transalveolar approach to elevate the sinus floor when placing implants on a severely resorbed maxillary posterior ridge with a buccal-palatal distance of more than 8.0 mm. In this approach, the osteotomy prepared on the crestal is bilaterally enlarged to 8.0-10.0 mm. The enlarged osteotomies can provide better access for practitioners, so that instruments can touch directly to the sinus floor and the Schneiderian membrane can be elevated with a reduced risk of perforation.

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