The aim of the present study is to clinically and radiographically evaluate the effect of the use of recently developed Smart Box accompanied with OT Equator attachment in retaining of the inclined implant assisted overdenture for atrophic maxilla and to compare the vertical bone changes around axial implants with OT Equator attachment and inclined implants with smart box attachment radiographically using CBCT

Inclusion Criteria:

• Male patients with comparable age (30- 65 years).
• All patients should have retruded, posteriorly atrophic completely edentulous maxilla with sinus pneumatization leaving less than 7mm bone height posteriorly and a sufficient amount of bone in the inter bicuspids region.
• Opposing mandibular dentate arch including bilateral posterior teeth.
• All patients should have an adequate zone of keratinized mucosa.
• All patients should be free from any intra-oral or systemic diseases that would otherwise affect the osseointegration of dental implants.
• All patients should be well motivated, cooperative, and with adequate manual dexterity necessary to place and remove removable implant prosthesis to provide adequate oral hygiene around the endosseous implants.

Exclusion Criteria:

• Patients with flabby maxillary ridges.
• Patients who are unwilling to accept implant overdentures as a treatment modality.
• Patients with temporomandibular and neuromuscular disorders.