The aim of this case report was to present the preliminary results of a novel microsurgical approach to sinus floor elevation and bone augmentation. This technique was used to treat four patients in whom an implant could not be placed in the maxillary first molar position because of insufficient bone height. The maxillary first molar was extracted, and a sinus access window was created in the palatal area of the bony interradicular septum. The sinus membrane with the palatal septum fragment was elevated, and the sinus space between and above the roots was filled with xenograft. Alveolar preservation was done with xenograft and a nonresorbable membrane. Bone augmentation was evaluated 6 months after preservation by computed tomography and histology; clinical, radiologic, and histologic bone reconstruction were seen, allowing placement of implants. The novel approach utilized in this study demonstrated positive preliminary results in bone reconstruction with reduced morbidity.