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With 4-5 mm remaining bone at #2, the initial osteotomy is 4.0x3.5 mm with regular drills with sharp end. After using 3.6 mm sinus drill with round end for ~ 4 mm in depth, water lifting is conducted smoothly. After use of the same safe drill for ~ 5 mm, water lifting is done. Nose blowing indicates possible sinus membrane perforation. With insertion of collagen plug (PRF is not prepared because of thin vein), mixture of autogenous bone and allograft is lifted with 4x9 mm dummy implant with a guide (Fig.1 G).
Xin Wei, DDS, PhD, MS 1st edition 10/29/2019, last revision 10/29/2019