Maxillary sinus surgery has always been the subject of discussion among advocates of the most traumatic technique through the vestibular porthole and supporters of crestal access.

There are elements, given mainly by the height of the residual crestal bone, i.e. the distance between the floor of the maxillary sinus and the bony ridge.
Twenty years ago, when I began to study and develop a strategy for lifting the floor of the maxillary sinus by crest, I began with a residual height of at least 5 mm, as Summers had suggested in 1994 and later Cosci. Gradually improving the technique and increasing the experience, I started using this technique even with residual bone heights of 3-4 mm, paying maximum attention to bone density and the slow and progressive lifting of the mucous membrane