Indications for implant-supported rehabilitation of the posterior atrophic maxilla: A multidisciplinary consensus among experts in the field utilising the modified Delphi method.

This consensus report focuses on establishing expert guidelines for implant-supported rehabilitation of the posterior atrophic maxilla, a region presenting anatomical and clinical challenges. Developed through a Delphi method involving 33 international and Italian experts from the Italian Academy of Osseointegration, the consensus emphasizes the importance of thorough preoperative planning, including diagnostic wax-ups and evaluation of maxillomandibular relationships, to optimize functional and aesthetic outcomes. Key findings highlight the critical role of sinus bony walls in bone regeneration, the necessity of assessing sinus bucco-palatal width when choosing between lateral and transcrestal sinus floor elevation, and the viability of tilted, trans-sinus, and pterygoid implants in selected cases. Zygomatic implants are recommended primarily as a last-resort option for completely edentulous elderly or oncological patients when conventional treatments are unsuitable. Despite positive literature on short implants, no consensus was reached regarding their routine use in this context.