Maxillary Sinus Augmentation in the Second Molar Region: How To Manage This?

Dr. K asks:

I would like to hear some opinions on how to manage a maxillary sinus augmentation in the premolar-molar region when the adjacent 2nd molar is still present and the sinus floor is very flat extending from the proposed implant sites back past the second molar region. Basically, I am curious about how people like to manage the region overlying the 2nd molar. My tendency has been to avoid this region. However, in the upcoming case it looks like the sinus membrane may tear if I take this approach. How do I avoid tearing the sinus membrane in the second molar area?

Thanks in advance.

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