This presentation will discuss concepts to maximize clinical success rates and outcomes for maxillary sinus augmentation in conjunction with dental implants. Piezosurgery vs. traditional approach with rotary instruments will be compared. Various graft materials, membranes and techniques for grafting the hyperpneumatized sinus will be reviewed. The concept of simultaneous placement of dental implants, along with grafting, will also be reviewed and presented in an evidenced-based fashion. Long-term clinical, radiographic and histologic findings will be discussed in relation to the predictability of this treatment. Alternative treatments will be also discussed.