Although bone graft around the implant is limited (Fig.3,4 *), the sinus membrane is lifted (in fact expanded by water) substantially (arrowheads, as compared to preop CT (Fig.4')).  The sinus membrane has shrunk/descended 3 months postop (Fig.6 arrowheads).  The implant is unstable.  A healing screw is placed.  Progressive loading is mandatory.