This study investigates the outcomes of a surgical procedure that is performed to increase bone support at a future implant site on the upper back jaw area. This procedure requires placing bone graft material and/or substitutes into the maxillary sinus. The average healing time for the graft is about 6 months. Then, the site will be ready for dental implant. The study will compare healing outcomes of two types of bone graft mixtures used on the same patient (right and left upper jaw regions). The outcomes will be evaluated through clinical examination but also by studying the quality of the tissue through tissue biopsies obtained from grafted sites.

Inclusion Criteria:

• Indication of bilateral sinus augmentation through lateral window technique to prepare maxillary right and left posterior edentulous sites for a single or multiple unit implant supported restorations.
• Systemically healthy with controlled conditions
• Periodontally healthy/controlled dentition
• No known chronic and/or seasonal sinusitis
• No previous ear, nose, throat, and sinus surgeries
• Non-smokers
• Willing to be treated with allograft, xenograft and/or synthetic bone graft materials

Exclusion Criteria:

• 1. Indication of sinus augmentation through indirect techniques (≥5 mm initial alveolar ridge height from crest to maxillary sinus floor)
• Implant placement surgery planned somewhere else
• Implant placement planned at the time of sinus augmentation
• Cases requiring major alveolar ridge augmentation concurrent with sinus augmentation
• Cases requiring the use of a partial denture with buccal flange extension during the post-operative period
• History of previously failed implant and/sinus augmentation procedures
• History of tumors and/or radiation and/or chemotherapy
• Uncontrolled systemic health problems and ENT/sinus concerns
• Uncontrolled periodontal/dental problems
• Intake of medications affecting wound or bone healing (e.g., corticosteroids, immunosuppressants, etc.)
• Alcohol or drug abuse
• Active smokers (patient should be a non-smoker for at least 1 year prior to sinus augmentation procedure)
• Unable/unwilling to follow post-operative instructions, rejecting to be treated with allograft, xenograft and/or synthetic bone graft materials
• Unable/unwilling to attend scheduled study visits
• Participation in another clinical trial within 3 months prior to planned study entry

Patients of the Graduate Periodontics Clinic at The Ohio State University College of Dentistry who missing their upper back teeth (both sides) and interested in having implant supported dental restorations