Insufficient crestal height may present in the posterior maxilla that will require osseous grafting to place implants. When sufficient height is present to stabilize the implant at placement, simultaneous sinus augmentation via a crestal approach with implant placement can be performed. The crestal approach when applicable has fewer complications then lateral sinus augmentation procedures and is more comfortable for the patient during the post operative period. This article shall describe the crestal sinus augmentation technique using special reamers that are safe ended to elevate the sinus membrane without potential tearing.