A 47-year-old man returns emergently with subgingival fracture of the lingual (L) cusp of the tooth #4 (Fig.1).   The sinus floor is immediately apical to the apex of the tooth.  The intent of immediate implant of this case is not to cause sinus membrane perforation.  No drill approach will be adopted.

No Drill Osteotomy

Xin Wei, DDS, PhD, MS 1st edition 11/26/2016, last revision 01/19/2018