Clinical and radiological outcomes of one stage maxillary sinus floor augmentation with synthetic HAp granules and dental implant insertion, mineralization degree of residual bone and augmented sinus part, morphological analysis of biopsies from HAp/host tissue hybrid were evaluated. 142 SEMADOS (BEGO) dental implant insertions in 68 patients were included in this study. Clinical and radiograph analyzes by quantitative radiodensitometry was done after 3 and 5 years. During this period 6 implants (4,2%) were lost. We found the decrease of radiodensity in HAp augmented maxillary sinus area and increase of radiodensity in the area of residual alveolar bone. In biopsies after 6 month biomaterial/host tissue hybrid consisted of small bone trabeculas, fibrious tissue and granules of irregular shape without inflammatory cells. Slow degradation of HAp granules by activity of osteoclast like macrophages was observed.