Sinus augmentation with a lateral window technique and delayed implant placement are the traditional treatment schedules when the residual alveolar bone height in atrophic posterior maxilla is less than 5 mm. This article presents a transcrestal window approach (TWA) to replace a missing first molar in an atrophic posterior maxillary ridge with 1 to 2 mm of residual bone height (RBH). Transcrestal sinus augmentation and delayed implant placement were performed. The antral pseudocyst that was located in the nasal wall of the maxillary sinus disappeared in the cone-beam computer tomography images taken after sinus elevation surgery. The 1-year follow-up visit showed that the implant was successful and the Periotest value was -4.8. This approach reduces discomfort to the patient. The TWA with an RBH of 1 to 2 mm is a minimally invasive method for maxillary sinus augmentation.
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