Purpose: The purpose of this study was to compare a newly designed trephine drill (SLA KIT, Neobiotech) with conventional rotary instruments for maxillary sinus floor elevation based on operative time, postoperative pain, and perforation rates. Materials and Methods: Twenty-five patients were treated with a bilateral sinus floor elevation procedure with rotary trephine and conventional instruments. One side was treated with conventional rotary instruments, while the contralateral side was treated with rotary trephine instruments, with a 2-week gap between surgeries. Operative time was measured with a chronometer in seconds as the time from soft tissue incision to primary closure of the incision with the last suture. Pain was scored on a 10-point visual analog scale at 24 hours after surgery. The presence of tears and perforations was determined by direct visualization and the Valsalva maneuver. Results: Twenty-five patients were included in the study. Operative time was shorter when the trephine drill was used (11.1 +/- 2.4 minutes) than with conventional rotary instruments (15.1 +/- 2.9 minutes). Sinus membrane perforation was observed in eight patients when conventional rotary instruments were used, while the trephine drill resulted in two sinus perforations. Mean pain scores were 2.01 +/- 0.11 after using the trephine drill and 2.25 +/- 0.76 when conventional rotary instruments were used. No significant difference was found in postoperative pain scores. Conclusion: The trephine drill technique may result in decreased perforation rates and operative time.