Fig. 1

Our approach surgical steps; (A) apply a simple mid-crestal incision for mucoperiosteal flap reflection, (B) drilling with pilot bur before reaching the cortical bone of the sinus floor by 0.5 mm, (C & D) follow the drilling sequence, ensuring the final drill used has a diameter 1 mm smaller than the implant, (E) manually insert the implant with clockwise movement, (F) Gently tent the sinus membrane to the full length of the implant (implant with a diameter of 4.5 mm and a length of 10 mm, B&B® dental implants, Italy)