The skull presents a series of dense bony buttresses that conform a protective frame around the different craniofacial cavities. The middle third portion presents two anterior buttresses (frontomaxillary and frontozygomatic) and a posterior buttress (pterygomaxillary). In certain situations these structural supports allow the rehabilitation of free upper extremities in atrophic jaws by positioning parasinusal angulated implants--thereby avoiding the need for more complex reconstruction techniques such as sinus lifting or autografting procedures. The present study presents a review of the literature on implant insertion in anatomical buttresses of the upper jaw.