Sphenopalatine artery Anterior & posterior nasal artery Infraorbital artery Posterior & middle superior alveolar artery Facial artery Palatine artery Anterior facial vein Pterygoid veinous plexus Submandibular lymphnode Maxillary division of trigeminal nerve (V2) MAXILLARY SINUS AUGMENTATION 
Maxilla is 35 times more edentulous than mandible Maxillary sinus continues pneumatization throughout life. The available bone is lost from the inferior expansion of the sinus after tooth loss, involving the residual ridge region The bone density in this region is also decreases rapidly an on average is the least dense of any oral region 
Lamellar Bone laid down Heating of bone beyond 47 C Poor vascular supply & low oxygen tension to site of implant placement Micromovemnets beyond 150 um during initial healing phase at bone- implant interface
Speeds up bone apposition Any grooves in the surface guide cell migration along their direction thereby allowing bone to adhere to even the tiniest irregularity Better interlock & biomechanical response Accentuates ability of Ti to integrate without inflammation.
Depends on bone quality & quantity Minimum distance between implant & adjacent natural tooth: 5mm Minimum distance between two adjacent implants from their centres:7mm
Ranges from 6mm to 20mm It is the measured from the height of the crest of the ridge to 1mm from the nearest anatomic limitation Aim in selecting length is bicortical stabilization Must be such that atleast 1 mm of healthy bone remains around the implant both buccally & lingually Bone density also governs implant width. Wider implants have better bone contact & greater cross section at the neck of the implant. The property of osseointegration is virtually exclusive to titanium. When Ti is exposed to atmospheric conditions forms a passivation oxide layer More extensive layer about 10nm in thickness formed in vivo Also been hypothesized that the actual Ti interface to the implant is a hydrated Ti peroxy matrix.
