When the tooth #15 is extracted, the socket floor looks shiny and hard for osteotomes.  Instead starter drill is used for initial osteotomy.  The sinus membrane perforates.  In fact the socket floor is the sinus floor.  Tatum tapered round osteotomes 2-5 mm are used for osteotomy.  The sinus membrane perforation increases.  The sinus floor is approximately 1 mm.  If Magic Sinus Lift were used, the sinus membrane perforation could be avoided.  A 4x9 mm IBS dummy implant is placed with stability (Fig.1, no bone immediately around the apical portion of the implant).

Drill Perforation Next Xin Wei, DDS, PhD, MS 1st edition 10/19/2017, last revision 09/06/2018