Best Approach for Internal Sinus Lifts?

Dr. Jack asks:

I would like to ask those out there who do routine implants around the maxilla region, what is the best approach to internal sinus lift? I have been to several courses but there are some variations and each with their own justification.

One suggests drilling with pilot drill to 1mm short of the sinus floor
then start using 2mm osteotome, place bone graft and continue lifting
with larger osteotomes.

Another approach is the hydraulic balloon lift system. I am not sure if
this works for internal sinus lift or not. Never tried it myself.

Also, another is to use osteotomes from start to finish. Presumably this is done for D3, D4 type bone.

What kind of approach are you guys using out there and that you find
easiest to do with good results and less chance of perforating the
sinus membrane?

See also: - Implant installment in the UL6 site: Thoughts on sinus lift?