Background: The aim of this narrative literature review was clinical indications as well as common complications of the most common treatment options for oral rehabilitation of the upper jaw. The paper also introduced a novel decision-making tool for guiding the selection of the most appropriate treatment for oral rehabilitation based on patients’ residual bone height, width, and quality. Methods: This study is a review article based on PubMed and Scopus that was done by reviewing articles from 2000 to 2022. Treatment choices for edentulous maxillae with the insufficient bone for implant placement comprise two broad classifications: bone defect compensation by bone augmentation techniques and modified implant designs for specific situations to utilize the remaining bone. The following factors have to be taken into consideration: the residual bony anatomy, remaining bone volume and quality, skeletal maxillomandibular relationship, scientific evidence, the experience of the clinicians, and, the patients’ increasing demands and expectations. Results: Grafting techniques are often demanding for both patients and surgeons. Likewise, they are associated with a prolonged treatment time, increased financial cost, and higher complication risks, especially in medically compromised patients. Several non-grafting alternative options have been reported such as zygomatic implants (ZIs), short implants, tilted implants, and the like. Conclusion:Oral rehabilitation in the upper jaw should follow a comprehensive assessment and examination of the patient’s quality and dimensions of residual bone. The clinical decision between grafting versus non-grafting options is associated with several factors.