A case report of severe bleeding after sinus floor elevation using the transcrestal approach was published in EJOI in the third issue of 2012 by Dr Simon Storgård Jensen and coworkers1. EJOI has received a letter regarding this case report from Dr Federico Mandelli and Dr Tiziano Testori. EJOI has decided to publish this letter together with the answers from the authors as well as minor comments from the EJOI editors. It is our hope that the letter and the reply will provide readers with improved interpretation and understanding of the case report presented.