In IV Class of Misch classification is usually not possible insert fixtures at the same time of the sinus lift procedure. To solve all these situations the use of several appliances has been proposed. Among those the S.I.S. titan plane is the easiest to use. The S.I.S. plane allows to stabilize implants without primary stability and to fix them to osseous ridge. In IV Class of Misch it brings to a real treatment shortening. After six and twelve months RX assessments show bone levels comparable to literature implant success criteria. This technique seems to reach success in Misch IV Class with simultaneous insertion of dental implants, with a simple procedure and without further trauma. Literature on S.I.S. plane is lacking and mostly based on case reports. A further investigation based on a larger number of patients is needed.