A = The implant bed is prepared with a series of osteotomes with increasing diameter or in combination with burrs to a depth approximately 1-2 mm away from the maxillary sinus floor boundary.
B = An up-fracture of the maxillary sinus floor is made with a mallet under light tapping and the Schneiderian membrane with the maxillary sinus floor is carefully elevated with the osteotome or a blunt instrument.
C = The implant is inserted in the residual alveolar bone with the implant tip exposed in the lifted area.
D = New bone formation around the implant tip in the previous created compartment.