A guide to Sinus lift Surgery

What is a sinus lift?

A sinus lift is a surgery that will add bone to your upper jaw and in the area of your premolars and your molars. A sinus lift is sometimes referred to as sinus augmentation. Bone will be added in between your jaw and your maxillary sinuses. They can be on either sides of your nose. In order to make room for the bone, the sinus membrane may be moved upward or lifted. A sinus lift is performed by a maxillofacial surgeon or a periodontist.

What is the sinus lift used for?

A sinus lift is performed when there is not enough bone in the upper jaw or the sinuses to hold dental implants. Here are some of the reasons sinus lifts are used

  • People who have lost teeth in their upper jaw like the back teeth molars may not have enough bone for implants to be placed. If you look at the anatomy of the skull, you will notice that there is less bone on the upper jaw than the lower jaw
  • Bone loss may have happened because of periodontal gum disease
  • Tooth loss may have led to bone loss because when teeth are gone, bone starts to get reabsorbed back into the body. If teeth have been missing for a long time then there may not be enough bone left for implants
  • The maxillary sinus could be too close to the upper jaw for the placement of implants. The size and the shape of the sinuses will vary among individuals. Moreover, the sinus may become larger as you get older

Sinus lifts have been widespread over the past fifteen years because more and more people are getting dental implants for their missing teeth

How do you prepare for dental implants?

Bone that is used for sinus lifts may come from your own body or from a cadaver. If your own bone will be used then it will be taken from other areas of your mouth or other areas of your body. In certain situations, the surgeon will remove bone from your hip or tibia. This is the bone that is beneath your knee.

You will need to go through several x-rays before having a sinus lift so that the dentist can study the anatomy of your jaw and the anatomy of your sinus. You may need to go through a computed topography scan as well. This scan will allow your dentist to precisely measure the height and the width of your current bone. This will also be used to evaluate the health of your sinus.

How is the sinus lift done?

Your surgeon will cut the gum tissue where your back teeth were previously located and the tissue will be raised. This will expose the bone. A small oval window will be opened in the bone and the membrane lining the sinus on the sides of the window will separate your sinus from your jaw. It will be pushed up gently away from the jaw.

Granules of bone-graft material will be packed into the space where the sinus was located. The amount of bone packed into it will vary but usually several millimetres of bone will be added. When the bone is in place, the tissue will be closed with stitches. The implants will be placed after four to nine months. This will depend on the type of graft material used. Time is needed for the grafted material to mesh with your bone.

What are the follow-up procedures for a sinus lift?

There will be swelling in the area after a sinus lift. There will be bleeding in your mouth and in your nose as well. You should not blow your nose or sneeze forcefully because this may cause the bone graft to move or it may loosen the stitches.

Your dentist will provide you with saline sprays in order to keep the inner lining of your nose wet. Medications that will prevent you from sneezing will also be applied. If you have seasonal allergies then you should schedule the procedure at an appropriate time of the year. You will be given pain medicine and antimicrobial mouthwash in order to prevent infection.

You must return to the specialist after a week or two so that the surgical site can be evaluated and the stitches be removed. You will be asked to return a few more times in order to monitor your progress.

After the sinus lift, you will have to wait for several months so that the bony material will harden and integrate with your jaw. Depending on the grafts that were used, the implants will be placed within four to nine months.

Specialists have started using proteins called growth factors that will help the new bone become hard faster. Platelets that are rich in plasma contain these growth factors and they are taken from your blood prior to surgery and then mixed with graft that is placed in your sinus. Human recombinant bone morphogenetic protein is engineered protein and it is readily available for bone formation without the grafting.

What are the risks involved in a sinus lift?

The main risk of a sinus lift is that sinus membrane may become punctured or it may be torn during the process. If the membrane is torn then the surgeon must be able to stitch it back together or place a patch over it. If the repair is unsuccessful then your surgeon will allow time for the hole to heal.

Your dentist will do the sinus lift when the membrane heals. It will take a couple of months. Healed membrane is thicker and stronger which means a second attempt for a sinus lift may be more likely to succeed. Keep in mind that there are also other factors that affect its success.

Infection is a risk of any surgical procedure and it hardly occurs after sinus lifts. On rare occasions, the existing bone will not integrate with the bony graft material. The grafted area will not develop a blood supply. If this happens then the implants placed in this area will fail because there is no bone to attach to. The sinus lift procedure will have to be repeated in this case.

After a sinus lift, you can contact your surgeon for

  • any swelling or pain that gets worse in time. This should decrease after the first two days
  • bleeding that does not stop after one to two days
  • bony material can be dislodged if you sneeze violently or if you blow your nose vigorously
  • pain that does not subside in time
  • fevers that develop

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