Immediate implant placement and immediate loading of single-tooth implants are reliable treatment options with high implant survival rates and good long-term results. Because of the anatomy of the roots immediate implant placement is usually performed in incisors, canines and premolars. If performed in molars the authors usually suggest to place the implant in the septa between the roots. In the majority of cases the vertical height in between the roots is insufficient for implant placement. In those cases a sinus-lift procedure after the healing of the socket is inevitable. The aim of the described workflow is to avoid a second invasive surgical intervention to place an implant together with sinus grafting procedures by immediate implant placement in the palatinal root. Keywords: Immediate implant placement, immediate reconstruction, sinus grafting, dental implant