BackgroundInsertion of an implant in the edentulous posterior maxilla is a challenging procedure because of poor bone quality and increased pneumatization of the maxillary sinus after tooth extraction. To increase the amount of bone, several surgical bone grafting techniques have been used?with considerable morbidity for patients. Osteotome sinus floor elevation (OSFE) is a less invasive technique. The clinical and radiographic outcome of 53 implants placed with this technique without bone graft has been reported previously. PurposeHere we report the clinical and radiographic findings after 10 years of implant load bearing. Material and methodsIn a retrospective study, 34 Astra implants in 25 patients were subjected to 10-year follow-up radiologically and clinically. Each patient received 1 or 2 conical Astra implants. The level of the marginal bone and the height of the residual peri-implant alveolar bone (RPAB) for each implant were measured from digital intra-oral radiographs. ResultsTwo implants in edentulous patients were lost at the 1-year follow-up, and 1 more at the 3-year examination. There was no loss between 3-year and 10-year follow-up. At 10-year follow-up 36 implants were included. Implants used in single-tooth replacements and in partially edentulous cases had a 100% survival rate. The mean marginal bone loss was 0.60.8 mm. The bone height at the time of implant insertion ranged from 1.8 to 6.9 mm, with a mean value of 4.3 +/- 1.0 mm. At 10-year follow-up the mean gain in bone at the implant sites for all implants was 2.6 +/- 1.2 mm. ConclusionsThe OSFE technique is a reliable method for rehabilitation of patients with atrophied posterior maxilla. However, the success of this method is associated with the amount of the residual bone. In the present study, this surgical approach without bone graft showed reliable long-term results with Astra implants.