Simple sinus and ridge augmentation
One large and another smalll bony communication was relvealed afer elevation of flap. Crestal sinus elevation is contraindication in this case, so piezoelectric RBO window was prepared to elevate sinus mucosa.
To prevent postop sinusitis, bone graft was not placed in this sius after repair of mucosal perforation wit fast resorbable gelatin sponge.
Two implants were placed at the same time as tenting pole and special tenting abutments were also placed to relieve pressure from soft tissue after wound healing.
All miracles at a time is not a difficult procedure.