Sinus Lift – Sinus Augmentation

A sinus lift is surgery that adds bone to your upper jaw in the area of your molars and premolars. It's sometimes called a sinus augmentation. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, the sinus membrane has to be moved upward, or "lifted."

What is sinus lift procedure for?

A sinus lift is done when there is not enough bone in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed. There are several reasons for this:

• Many people who have lost teeth in their upper jaw — particularly the back teeth, or molars — do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw. The relative size and shape of any individual's upper jaw, and the size and shape of their maxillary sinus, will vary. (The size of the sinus can also change with age.)
• Bone may have been lost because of periodontal (gum disease). In situations where advance periodontal disease(gum disease) is present, the bone that surrounds and supports the person's teeth is damaged. In the most severe cases, significant amounts of bone can be lost to the point where there is no longer an adequate amount of bone in which to place a dental implant.
• Bone resorption associated with previous tooth extractions. Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed. If teeth have been missing for a long time, there often is not enough bone left to place implants.
• The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus vary from person to person. The sinus also can get larger as you age.

Sinus lifts have become a common dental procedure during the last 15 years as more people get dental implants to replace missing teeth.

Procedure

The dental implant surgeon enters the sinus by cutting the gum tissue where your back teeth used to be. The tissue is raised, exposing the bone.

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• A small, oval window is opened in the bone. The sinus membrane is then gently lifted upward. Granules of bone grafting material are then packed into the space where the sinus was. The amount of bone used will vary, but usually several millimeters of bone is added above the jaw.

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• If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant initially (>3 mm), sinus augmentation and implant placement can sometimes be performed at the same time (single procedure).

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• If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for 6-8 months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed as a second surgical procedure.

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• The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing partial or full dentures.

Case example 1: Sinus lifting and implant surgery done by Dr. Ken Kasidis

Follow-Up

After the procedure, you may have some swelling of the area. You may bleed from your mouth or nose. Do not blow your nose or sneeze forcefully. Either one could cause the bone-graft material to move, and loosen the stitches.

Our implant surgeon will prescribe medicine (antibiotics, pain medicine, antimicrobial mouthwash and nasal decongestant) to prevent infection, post-operative pain and swelling. If you have seasonal allergies, you should schedule the procedure when they are not active. You also will be given pain medicine, an antibiotic and an antimicrobial mouthwash to help prevent infection. Most patients have only a little discomfort after a sinus-lift procedure.

You will see our implant dentist after 7 to 10 days. He or she will evaluate the surgical site and possibly remove stitches. You probably will be asked to return a few more times to make sure the area is healing properly.

After a sinus lift, you need to wait several months (4-8 months) for the bony material to harden and integrate with your jaw. Depending on the grafting material used, implants may be placed in four to nine months.

Risks

The main risk of a sinus lift is that the sinus membrane could be perforated or torn. If the membrane is torn during the procedure, the surgeon will place a patch (a collagen membrane or collagen dressing) over it. If the repair is not successful, your surgeon may stop the procedure and give time to heal.

Your dentist can redo the sinus lift once the membrane has healed. This usually takes a few months. A healed membrane tends to be thicker and stronger, which means a second attempt at a sinus lift is likely to be successful. However, other factors also affect success.

Infection is a risk of any surgical procedure. However, this rarely occurs after sinus lifts.