Implant healing following maxillary sinus floor augmentation takes place in a composite bone milieu where new bone, remaining xenograft granules, mineralized bone interconnections, marrow cavities, and soft tissues compete for implant contact area space. In this research paper, we explored whether greater osseointegration found with a moderately rough ZirTi mini-implant surface results from higher peri-implant bone density in 400 μm peri-implant tissue region or from more efficient use of tissue distribution in implant contact area. The data set was taken from a clinical histomorphometry trial where lateral sinus floor elevation had been performed with bovine hydroxyapatite granules, with or without collagen membrane covering the lateral window. After 6 months of graft healing, two paired mini-implants with ZirTi and turned surfaces had been installed, extracted following 3-month period of submerged healing, and histological evaluation done. Finally, 14 pairs of specimens remained in the sample set, which comprised 6 patients in membrane group and 8 patients in no-membrane group. Implant contact parameters provided assessment of new bone, interconnecting bone network, old bone, residual bone graft, and soft tissue at implant surface, whereas 400 μm point counting assessed new bone density, total bone density, old bone density, residual bone density, and soft tissue density in peri-implant tissue. No statistically significant differences were found between ZirTi and turned implants regarding new bone density (22.9% and 21.5%, respectively) and total bone density (30.1% and 29.9%) within 400 μm from the implant surface. However, there was a difference in implant contact area: new bone contact percentage on ZirTi was 29.8% and total bone contact – 39.6%; at turned implants, corresponding percentages were 10.0% and 20.6%. Soft tissue contacts amounted to 29.7% and 52.5% at ZirTi and turned surfaces, respectively. The direct anchorage index, bone-to-soft-tissue ratio, and composite bone ratio were higher at ZirTi surfaces. Thus, surface topography had no effect on peri-implant bone density but led to favorable tissue distribution in implant contact area in favor of bone-to-soft tissue balance.