Aim: The study aimed to assess the clinical results of a treatment protocol for performing both localized sinus augmentation and socket preservation at the time of maxillary molar and premolar extraction in cases with compromised residual bone heights. Materials and methods: 7 patients aged from 32 to 74 years old with existing severe attachment loss and hopeless teeth due to periodontal disease were enrolled in this study. The described technique was performed in 10 sockets following tooth extraction in the maxilla (7 molars and 3 premolars). After a healing period of three months cone beam computerized tomograms (CBCT) were taken, compared to preoperative radiographs, implants were inserted and followed up clinically and radiographically. Results: Compared to preoperative alveolar heights the average primary sub-antral bone height was increased by 3.4 mm. Through this technique, the number of cases with an indication for an conventional sinus floor elevation in conjunction with lateral window was reduced by 100% (7 vs. 0). 10 implants with lengths from 11-13 mm were placed. All implants could be placed primary stable. No further soft tissue corrections were needed. All implants were clinically stable and osseointegrated at the time of implant uncovering and follow up evaluation after loading. Disclosure: The described procedure verified that it improves the clinical condition for future implant placement in compromised initial situations, when distinct alveolar defects and reduced residual bone height are expected. Keywords: Implant, socket preservation, sinus floor augmentation, periodontitis