Simultaneous Implant Placement With Autogenous Bone Ring

Inclusion Criteria: * Patients with edentulous vertically deficient posterior maxillary ridge a 4-5 mm. height of alveolar bone. * Both males as well as females without any active periodontal disease. * All patients are in a good health with no systemic, immunologic or debilitating diseases that could affect normal bone healing. * All selected patients are non-smokers and non-alcoholics. * Patients are free from T.M.J troubles, abnormal oral habits such as bruxism. * The edentulous ridges are covered with optimal thickness of mucoperiosteum with no signs of inflammation, ulceration or scar tissue. * Remaining natural teeth have good periodontal tissue support and occlusion showed sufficient inter arch space for future prosthesis. Exclusion Criteria: * On the local level, patients with maxillary sinus diseases, former sinus surgery and unfavorable inter maxillary relationship will be excluded. * General contraindications to implant surgery. * Subjected to irradiation in the head and neck area less than 1 year before implantation. * Untreated periodontitis. * Poor oral hygiene and motivation. * Uncontrolled diabetes. * Pregnant or nursing. * Substance abuse. * Psychiatric problems or unrealistic expectations. * Severe bruxism or clenching. * Immunosuppressed or immunocompromised. * Treated or under treatment with intravenous amino-bisphosphonates. * Lack of opposite occluding dentition/prosthesis in the area intended for implant placement. * Active infection or severe inflammation in the area intended for implant placement. * Need of bone augmentation procedures at implant placement. * Unable to open mouth sufficiently to accommodate the surgical tooling. * Patients participating in other studies, if the present protocol could not be properly followed. * Referred only for implant placement or unable to attend a 5-year follow-up.