Sinus pneumatization is a continuous physiological process that occurs naturally and causes an increase in the volume of paranasal sinuses. Pneumatization is also frequently observed following extraction of teeth in the posterior maxilla. This leads to an increase in the sinus volume and height at the expense of the edentulous alveolar ridge. These changes may affect treatment planning if dental implants are indicated to replace extracted teeth. Using a novel method to align and compare two panoramic radiographs taken before and after tooth extraction, we aimed to examine post-extraction dimensional changes in the maxillary sinus and alveolar ridge by superimposition of preand post-treatment panoramic radiographs. Twenty-two pairs of panoramic radiographs were analyzed retrospectively for changes in alveolar ridge and maxillary sinus dimensions following at least 6 months from tooth extraction. Pre- and post-extraction radiographs were matched and then superimposed using a fixed reference unit. Measurements included the distance from bone-crest to sinus-floor and to sinus-roof, as well as distance from sinus-floor to sinus-roof and maxillary-sinus sagittal circumference. The mean difference between pre- and post-extraction bone-crest to the sinus-floor radiographic measurements was statistically significant ($P =$ 0.001) with a mean change of 1.2 mm. The difference between pre- to post-extraction bone-crest to sinus-roof measurements was insignificant ($P =$ 0.094) with a mean change of 0.9 mm. The distance between pre- and post-extration sinus-floor to sinus-roof was significantly increased in an average of 1 mm ($P =$ 0.001) along with an increase in sinus sagittal circumference from 993.9 $\pm $ 295.7 mm to 1096.6 $\pm$ 312.5 mm ($P <$ 0.0001). In conclusion, a moderate increase in maxillary sinus dimensions concurrent with crestal resorption may be anticipated after extraction of maxillary posterior teeth, leading to an overall decrease in alveolar bone height.