Management of the posterior maxilla in the compromised patient: historical, current, and future perspectives

Anatomic factors include decreased bone quantity, especially in older edentulous or partially edentulous patients who have experienced alveolar resorption in the wake of tooth loss. The antrum also tends to enlarge with age, as well as with edentulism, and this further decreases the amount of available bone. In addition to the diminished quantity, bone in the posterior maxilla often is softer and of poorer quality. Radiographs typically reveal a dearth of trabeculations, and the tactile experience of drilling here often more closely resembles the penetration of styrofoam rather than anthracite. Limited access to the pterygomaxillary region constitutes yet another problem.