The authors present their experience in 43 cases of maxillary sinus augmentation with autologous bone and hydroxylapatite granules via a lateral maxillary approach. During the same operation or after six months, according to width and height of the residual alveolar ridge, hydroxylapatite coated titanium endosteal implants (IMZ) were inserted in the maxilla; after an additional healing period of 6 months, dental prostheses were applied; the mean follow-up was 14.5 months (range: 12-24 months). Out of 124 implants inserted in the grafted sinuses, 8 failed, with a 93.5% success rate, whereas of 38 implants inserted in the grafted sinuses, 8 failed, with a 93.5% success rate, whereas of 38 implants inserted in the anterior maxilla, 2 (5.3%) failed. The results from this preliminary report indicate that composite bone grafting of the maxillary sinus is a very reliable technique that provides the bony structure for correct placement of endosseous implants.