Bone density proves to be not low intraoperatively.  First, when the 1.6 mm pilot drill is being used, the bone does not feel soft.  Second, the first expander (2.6 mm, Fig.2 E) cannot be driven into the osteotomy (following the pilot drill) unless 2.5 mm reamer is used.

Arrowheads: sinus floor.

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Xin Wei, DDS, PhD, MS 1st edition 08/12/2014, last revision 09/30/2018