The vertically deficient posterior maxilla often requires augmentation to allow implant placement. Using live surgery and an extensive video library, this course will review traditional Trans-alveolar Sinus Elevation (TASE) techniques with osteotomes and discuss in detail an advanced osteotome technique using Contiguous Sinus Floor Elevation (CSFE). CSFE offers predictable large elevations (5-8 mm) as a minimally invasive approach with minimal instrumentation and often simultaneous implant insertion. Sinus floor elevation at maxillary extraction sites and adjacent edentulous areas can offer patients immediate implant reconstruction. These techniques offer a faster healing interval and minimal discomfort. Cone Beam CT imaging is important for evaluation of alveolar dimensions, sinus anatomy and pathology for appropriate technique selection. Preservation of the periosteal micro-vascular supply guide flap design and the application of micro-flaps and "flapless" techniques will be presented. We will discuss progressive skill development and CT diagnosis to avoid complications.