What Is It?
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 It's Used 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.
- Bone may have been lost because of periodontal (gum) disease.
- Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). 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 varies from person to person. The sinus also can get larger as you age.
- Sinus lifts have become common during the last 15 years as more people get dental implants to replace missing teeth.
The bone used in a sinus lift may come from your own body (autogenous bone) or from a artificial (usually bovine in origin).
If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth.
You may need X-rays taken before your sinus lift so the implant surgeon can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan. This scan will allow the implant surgeon to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.
How It's Done
Your surgeon will make a small incision in your gum where your back teeth used to be. The gum is raised, exposing the bone. A small, oval window is opened in the bone. The membrane lining the sinus on the other side of the window separates your sinus from your jaw. This membrane is gently pushed up and away from your jaw.
Granules of bone-graft 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.
Once the bone is in place, the tissue is stitched closed. Your implants will be placed four to nine months later. This allows time for the grafted material to mesh with your bone. The amount of time depends on the graft material that was used.
It is often possible to place the implants simultaneously.
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.
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 the implant surgeon after 7 to 10 days. He will evaluate the surgical site and possibly remove stitches.
If the implants are not placed at the same time as the sinus lift procedure, you need to wait several 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.
The main risk of a sinus lift is that the sinus membrane could be punctured or torn. If the membrane is torn during the procedure, the surgeon will either stitch the sinus tear or place a patch over it. If the repair is not successful, your surgeon may stop the procedure and give the hole time to heal.
Your implant surgeon 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.
Infection is a risk of any surgical procedure. However, this rarely occurs after sinus lifts.
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Sinus lift: This is a routine surgical procedure to regenerate bone in the upper posterior jaw. A window is made in the bone, and the floor of the maxillary sinus is elevated. Graft material is placed under the floor, and the site is allowed to heal for future implant placement.
The first picture (above) shows an initial implant hole (osteotomy) made under the sinus floor. The second picture shows the sinus floor being pushed up with an elevation instrument.
The first picture (above) shows a bone graft placed under the sinus floor. The second pictures shows a dental implant placed under the sinus floor into the graft material.