This article describes a new methodology for augmentation of the bone at the sinus floor that is less invasive than previous techniques. This procedure is called the osteotome technique. Two different applications of the osteotome technique are described. First an implant site is created in a location that previously had inadequate bone for immediate fixation of an implant. In a second surgical step additional augmentation of the bone is carried out when the implant is inserted. This case report provides details, from the original ridge defect with 1 to 2mm of bone under the low sinus to the final esthetic crown restoration on a 5 x 13-mm external-hex screw implant that is supported by newly generated bone.