Dental implant therapy in the posterior maxilla may be difficult owing to limited bone height after dental extraction with sinus pneumatization. Several approaches for sinus floor elevation have been documented, and hence flapless transcrestal sinus floor elevation is minimally invasive technique which is used in moderately defected maxilla.

Aim of the study: to evaluate both clinical and radiographic outcomes in sinus floor elevation following dental implant placement using flapless transcrestal sinus lift approach with Titanium platelet rich fibrin (TPRF) as a sole sinus graft material compared to Platelet rich fibrin (PRF).

Inclusion Criteria:

• Patient seeking replacement of a missed maxillary posterior teeth by a delayed dental implant procedure.
• Residual bone height is (4-7) mm measured from crestal bone to sinus floor.
• Good oral hygiene

Exclusion Criteria:

• Uncontrolled Diabetes.
• Coagulation disorders.
• Immunological disorders.
• Previous radiation of the head and neck region.
• Abnormal bone physiology.
• Therapy with Bisphosphonates.