What Is It?
A sinus lift, sometimes called a sinus augmentation, is surgery that adds bone to your upper jaw in the area of your molars and premolars to make it taller. 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.” A sinus lift usually is done by an oral and maxillofacial surgeon or a periodontist.
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.
- 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 among individuals. In addition, the sinus can get larger as you age.
Sinus lifts have become common over the past 15 years as more people are getting dental implants to replace missing teeth.
The bone used in a sinus lift may come from your own body (autogenous bone) or from a cadaver (allogeneic bone). Synthetic materials, which can stimulate bone formation, also are used sometimes. If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth or body. In some cases, the surgeon removes bone from your hip or your tibia (the bone beneath the knee).
You may need X-rays taken before your sinus lift so the dentist can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan 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 cut the gum tissue near your premolars and molars. The tissue 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, depending on the graft material that was used. This allows time for the grafted material to mesh with your bone.
After the procedure, you may have some swelling of the area, and may bleed from your mouth or nose. You should not blow your nose or sneeze, because these activities can cause the bone-graft material to move, and can cause the stitches to loosen.
Your dentist may give you saline sprays to keep the inner lining of your nose wet and prescribe medication to prevent sneezing. If you have seasonal allergies, you should schedule the procedure when they are not active. You also will be given pain medication, 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 specialist after 7 to 10 days to have the sutures removed, and for the specialist to see how you are healing. Your 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 for the bony material to harden and integrate with your jaw. Once this happens, the implants will be placed.
If your own bone is used in the procedure, you may wait as few as six months. If cadaverous or synthetic bone is used, you will need to wait longer, usually nine to 12 months.
Some specialists have started using proteins called growth factors to help the new bone harden faster. Platelet-rich plasma, which contains the growth factors, is taken from your blood before surgery and mixed with the graft that is placed into your sinus.
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 graft material cannot be contained, your surgeon may stop the procedure and give the perforation time to heal. Your dentist can redo the sinus lift once the membrane has healed, usually a few months later. 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 following sinus lifts.
On rare occasions, your existing bone does not integrate with the bony graft material, and the grafted area does not develop a blood supply. If this happens, any implants placed in this area will fail because there is no live bone for them to attach to. If this happens, you can have the sinus lift procedure repeated.
When To Call A Professional
After a sinus lift, contact your surgeon if:
- Any swelling or pain gets worse over time. (It should decrease after the first two days or so.)
- The bleeding does not stop after one to two days.
- You think the bony material may have been dislodged after sneezing or blowing your nose.
- Pain does not decrease over time.
- You develop a fever.