I treatment planned this patient for four implants in #4, 5, 12 and 14 sites. Patient already had an implant in #13 site. I advised the patient that he would need a sinus lift and bone graft on the left for #14 as there was only 6.5mm of vertical bone height. He declined the graft so I placed the implant without the graft. The implant is 4.3x8mm. I achieved good primary stability of 35Ncm. The post-op radiograph showed that #14 had perforated the sinus. I prescribed an antibiotic, antihistamine spray and steroids. I advised the patient that if #14 developed complications, I would have to remove it and do a sinus lift and bone graft and try again. Do you have any recommendations on how to proceed? Some studies show that the membrane will form over the implant apex projecting into the sinus. Patient is returning for 2-week post-op. Should I reverse torque out the implant? What are the key signs and symptoms I should be focusing on?