What Is Sinus Lift Surgery
Sinus Lift Surgery is known by several names. The correct medical term is maxillary sinus floor augmentation. It is also known as sinus augmentation or sinus graft.
Sinus lift surgery is done to increase the amount of bone in the upper jaw to facilitate the placing of dental implants. The upper jaw is known as the posterior maxilla hence the name maxillary sinus floor augmentation.
The procedure requires the use of a bone graft that will come from either yourself , cadaver bone, or even synthetic bone.
Here is the basic process for the procedure:
- The patient is sedated with a combination of medicine that involves both local anesthesia and a general anesthetic. This is done at the discretion of the dentist/oral surgeon and depends on how involved the procedure may be.
- Next the surgeon will begin the procedure by cutting away at the gum tissue where your missing teeth used to be. This cut will extend until the jawbone is reached.
- Once the jawbone is exposed, the doctor will open a small area into the bone through which they can gently push on the membrane of the sinuses.
- The piece of bone that was cut is pushed into the sinus cavity space and the empty area behind it in the jaw is filled in with the bone grafting material.
- At this point the incision is closed with sutures and the patient can be awakened.
What Are The Potential Risks Of Sinus Lift Surgery
1) Puncturing The Sinus Membrane
Several complications can happen after you have had sinus lift surgery. The most likely risk is puncturing the Schneiderian membrane.
During a sinus lift surgery, it is impossible to see the sinus. Thus the surgery is done blindly so there is a risk of accidentally damaging this membrane. When this happens it may lead to other issues. There is a possibility of developing sinusitis.
A punctured sinus membrane may also cause the maxillary sinus and oral cavity to communicate abnormally. Other complications include, the nose shedding graft particles or nose bleed.
2) Inadequate stability for dental implant
Another risk of sinus lift surgery is inadequate stability. If the procedure is not done properly it can affect the stability of the dental implant. For the implant to be successfully inserted and last, the height and width of the bone must be sufficient.
If the sinus lift surgery is not properly done the bone volume may not be enough to accommodate the dental implant. This will prevent the implant from having adequate stability.
3) Infection
An infection is the most common complication associated with surgical procedures. The site where the operation was done can become infected for various reasons. This may be due to bad oral hygiene or the sinus being diseased. Also, the surface of the implant or the graft material may be contaminated. Keen attention must be given by both medical professionals and patients to avoid infections.
Who Needs A Sinus Lifting
Implants have been one of the most common treatments recently. However, we cannot say that a dental implant is a simple procedure. As you might already know, dental implants are placed in the jawbones. Unfortunately, some people dont have a healthy jawbone due to teeth loss or bone loss. Those people are advised to have a sinus lift before getting their implants placed. By sinus lifting, the surgeon opens some more space for bones to be worked on. Hence, your bones can support the implants more strongly and comfortably.
If you have lost teeth in your upper jaw and your bone has been reabsorbed in your body, you might need a sinus lift operation before getting dental implants abroad. The good news is that not all cases of tooth loss end up with a lack of bone, so you dont need to be worried about that very much. However, there are some more factors resulting in bone loss. One of the most common ones is periodontal gum disease. Although you are not losing any teeth, you might have bone loss inside your jaw if you are suffering from periodontal gum disease.
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Why Do I Need A Sinus Lift
Located immediately behind your cheeks and above your upper teeth are the maxillary sinuses which are basically vacant air-filled spaces. Some of your upper teeths roots reach up into the maxillary sinuses, and when these teeth are removed, often just a shallow wall of bone is left behind. Because dental implants need bone to keep them in place, when that wall is not substantial enough, it is virtually impossible to insert implants securely. A successful, long-lasting dental implant hinges on the quality and quantity of jaw bone to which it will be attached. In the event of bone loss due to trauma and/or periodontal disease, a sinus lift raises the sinus floor and allows for new bone development. One of the most common bone grafting procedures for dental patients, the sinus lift bone graft procedure aims to grow bone in the floor of the sinus, enabling dental implants to be anchored in this new bone growth.
Understanding The Sinus Lift
A sinus lift occurs when a dentist lifts the sinus floor to create enough room for the bone necessary for a dental implant. The area can be raised, although sometimes a separate graft is required for producing an anchor. The dental implant will not secure well if the sinus floor is too shallow and doesnt provide enough room for the implant anchor.
A dentist will perform the lift by making an incision in the back part of the gum area. A small portion of the bone near the sinus membranes will be cut and lifted into the sinus cavity area. The membrane rises at this point, producing the necessary room for the implants. A bone graft may also be necessary for anchoring the space, although synthetic material can also work in the area. The incision site is then sealed off with sutures.
The recovery process will vary, but it can take about 6 12 months to heal. The bone graft or implant will require enough time to heal to ensure youll have enough room for the new implant. Our dentists at Premier Periodontics in Bellevue, WA can help you with the recovery process and guide you in understanding what youll need to do when recovering from the procedure.
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Why You May Need A Sinus Lift Before Dental Implant Surgery
A sinus lift is not a procedure that most people think about before dental implant surgery, but it is a process that may be necessary for some. The lift entails raising a portion of the sinus floor to allow new bone to develop. The practice makes it easier for a dental implant to fit in a target area. Our dental team at Premier Periodontics is highly skilled in this bone grafting technique that can increase your candidacy to make implant dentistry possible in Bellevue, Everett, Kent, Kirkland, Mercer Island, Olympia, or Redmond, WA.
What Happens During The Sinus Augmentation Procedure
The sinus lift procedure is a safe and straightforward procedure. A sinus augmentation is generally performed at the prosthodontists or oral surgeons office. The entire process takes between 90 minutes to two hours.
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What Happens Before A Sinus Lift Surgery
If you’re getting sinus lift surgery, your dental professional will first determine where they’ll get the extra bone. The three most common types of bone used in sinus lift surgeries are:
- Autogenous bone: bone from your own body
- Allogenic bone: bone from a cadaver
- Xenograft: bone from a cow
If the bone comes from your own body, it will come from other areas of your mouth or body.
You’ll then need to get X-rays taken. X-rays allow the surgeon or dental specialist to study your jaw and sinuses so they can figure out precisely what you need.
Sinus Augmentation Surgery & Bone Grafting
The sinus system has several components, with the maxillary sinuses closest to our teeth. This is why you might get toothache if you have a bad cold pressure on the sinuses transfers to tooth roots in the upper jaw.
The sinus lift procedure involves raising the maxillary sinus membrane to make space for a bone graft. Thats why its medically known as maxillary sinus floor augmentation.
Anaesthetic options for a sinus lift include local anaesthesia, general anaesthesia, and intravenous sedation or nitrous oxide sedation .
The procedure usually takes 90 to 120 minutes and entails:
- Making an incision in the gum, where your teeth used to be.
- Lifting gum tissue to expose the bone.
- Opening a small area in the bone.
- Moving the membrane that lines the sinus upwards and away from the jaw.
- Placing bone graft material where the sinus was.
- Closing the tissue with stitches.
Implants are usually inserted months later to allow the graft to combine with the natural bone. The length of time depends on the amount of additional bone required.
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Dental Implants: Will I Need A Traditional Sinus Lift Also Know As Sinus Augmentation Or Sinus Grafting
A sinus lift is a common dental surgical procedure that can be performed prior to, or at the time of, dental implant placement. In this procedure, the bone and related anatomy at the bottom of the sinus cavity is augmented to create the needed vertical height to provide a more ideal environment for a dental implant.
To best position you for a successful implant, Dr. Steven Koos, your implant dentist serving Downtown Chicago, will need to assess the proposed location for your replacement tooth. If the quality or quantity of the bone structure is deemed inadequate, the implant may fail to heal properly if bone grafting is not done due to a lack of vertical support. Fortunately, this determination does not necessarily prevent you from enjoying a healthy dental implant. Instead, additional procedures may be recommended to provide increased support for the new tooth.
As it related to the actual sinus cavity, a sinus lift can only be performed in the upper jaw. A sinus lift is never relevant when an implant is used to replace a missing lower tooth. When an upper tooth needs to be replaced with a dental implant, the location of the floor of the sinus cavity should be verified with the use of advanced 3D dental x-rays. If roots of the upper teeth tend to extend towards and into the sinus, then it is reasonable to expect that the proposed dental implant will also extend into the same area.
Making Painful Sinus Lift Dental Implants A Thing Of The Past
Visiting the dentist can be very unpleasant for up to 20% of dental implant patients. In these cases, an invasive surgical procedure called a sinus lift is required. This involves separating the delicate membrane from the floor of the maxillary sinus above the upper jaw in order to insert a bone graft and make the jawbone thick enough to support an implant.
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Sinus lifts can be a particularly unpleasant experience for patients. The procedure takes more than an hour and involves significant trauma. Patients need to rest at home for three to 10 days due to the pain, discomfort, and severe, unattractive facial swelling and bruising. Six to nine months after the procedure, new bone is generated, and a second procedure is required to insert a dental implant into the newly formed bone. This is followed by a three- to five-month waiting period for the dental implant to be integrated into the bone when the prosthetic tooth can finally be inserted.
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As background, the maxillary sinuses are two hollow cavities located behind the cheekbones and just above the upper molar teeth in the back of the mouth. As people age, the sinuses expand and the jawbone shrinks in size. If upper molars are lost, the bone reduction is even more severe. In more than 50% of these cases, the remaining jawbone lacks sufficient volume to support a dental implant.
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How Did I Know That I Needed Sinus Lift
When you visit the dentist for implant, they advise you on the CT scan report of your jaw to check the availability of bone to place the implant. The most common problem encountered in the upper jaw thats insufficient bone in the upper molar region near the maxillary sinus. Resorption of bone is occurring due to severely infected teeth, prolonged gums disease, and longer duration after the teeth removal.
Once the CT-scan shows the least room for implant placement, the procedure is advised by the dentist to gain bone height. With the help of it and bone graft we are able to place implants to restore missing teeth.
Sinus Lifting Procedure: Step
The sinus lift procedure is a safe and uncomplicated procedure. A sinus augmentation is typically carried out at the prosthodontists or oral cosmetic surgeons office. The entire procedure takes between 90 minutes to two hours.
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C How Is The Sinus Lift Procedure Performed
The specific technique that a dentist uses can vary. But traditionally this surgery has been performed as follows:
A sinus lift increases the thickness of bone.
Lateral window technique.
- The dentist will make an incision in the patients gum tissue on the cheek side of their upper jaw in the region where the placement of the dental implant is planned.
After making the incision, the dentist will flap back the patients gum tissue and expose the surface of the jawbone that lies underneath.
- The exposed bone is cut in a fashion where a trap door of bone is created. This movable section of bone is then pushed gently inward and upward into the sinus cavity.
The bone movement will carry the sinus membrane along with it, thus lifting the membrane to a new, higher level.
The empty space underneath the lifted sinus membrane is then packed with bone-grafting material , thus providing the new bone into which a tooth implant can be placed.
- Once the bone-graft material has been positioned, the gum tissue flap is stitched back in place.
- In some instances, it can be possible that the dentist will place the dental implant at the same time that the sinus lift is performed.
In most cases, however, a dentist will allow a healing period of six to nine months before the dental implant is placed. The specific time frame allowed for healing is dependent upon the type of bone-graft material that has been used.
The bone graft materials are placed through the sinus window opening.
Complications And Its Management
Sinus membrane perforation is the most common intraoperative complication, which occurs in 7%35% of sinus augmentation procedures. Factors that affect sinus membrane perforation during osteotomy include vigorous instrumentation during elevation and thickness of the sinus membrane. Sinus membrane perforation increases rates of postoperative sinusitis and graft failure. Vlassis and Fugazzotto proposed a classification system for elevation and treatment. If a membrane is perforated when creating the lateral window outline, the osteotomy is extended several millimeters beyond the original window to reestablish contact with the intact membrane. If membrane perforation occurs during the lifting of sinus membrane and is a small defect of < 2 mm it can be left to heal itself but if the perforation is more than 2 mm, the opening can be patched with a piece of hydrated resorbable collagen barrier that’s large enough to cover the tear by several millimetres.
Other complications are related to the presence of preexisting antral pathologies, such as rhinosinusitis, odontogenic sinus diseases, pseudocysts, retention cysts, and mucoceles.
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When Do I Need To Worry About Complication After This Surgery
Like any other surgical procedure, sinus lift surgery has its complications. However, when you experience certain complications you should contact your surgeon:
- You Sneeze Out Graft Particles
- Abnormal Air or Liquid Flow Between Your Nose And Your Mouth
- Consistent congestion in one or both nostrils
- Swelling in your face that worsens after the 3rd post-op day
- Bleeding out of your nostrils that is more than the occasional drop
Your surgeon will give you an emergency number to call if you are experiencing any of these complications.
All in all, a sinus lift surgery is needed to increase bone volume to accommodate dental implants. This bone may collapse due to tooth loss or decay, or trauma. The procedure is not necessarily painful but it does have its downsides. If you experience certain complications like increased swelling, the expulsion of grafts from the nose, or congestion, you should contact your surgeon.