Sinus lift, also known as sinus floor elevation, is a dental surgical procedure that involves adding bone material to the upper jaw in the area of the molars and premolars to make space for dental implants. The procedure is called a sinus lift because it involves raising the sinus membrane to make space for the bone graft.
When Sinus lift is necessary?
A sinus lift may be necessary for individuals who have lost teeth in the upper jaw due to trauma, gum disease, or decay, and want to replace them with dental implants. The bone in the area of the missing teeth may have resorbed, leaving insufficient bone material to support a dental implant. A sinus floor elevation can add bone material to the upper jaw, allowing for the placement of dental implants.
Candidates for this surgery are:
- People who do not have enough bone density in their upper jaw
- when you have bone loss due to gum disease.
- Individuals who have lost their bones
Types of Sinus Lifts
There are two types of sinus floor elevation:
- Lateral window sinus lift
- Osteotome sinus lift
The lateral window sinus floor elevation involves making a small incision in the gum tissue near the premolars or molars. The surgeon then lifts the sinus membrane upward, creating a small space between the bone and the membrane. Bone material is then placed into this space, and the gum tissue is sutured closed.
The osteotome sinus floor elevation is a less invasive procedure that involves using a special tool called an osteotome to gently lift the sinus membrane and compress the existing bone in the area. This compresses the bone, creating a space that can be filled with bone material. The osteotome sinus lift is less invasive than the lateral window sinus lift, but it may not be suitable for all patients.
Lateral Window Sinus Lift
The lateral window sinus lift, also known as the crestal approach, is the traditional and most commonly performed type of sinus floor elevation. It involves creating a small incision in the gum tissue near the premolars or molars and raising a flap of tissue to expose the underlying bone.
Once the bone is exposed, a small window is created in the bone to access the sinus membrane. The membrane is gently lifted, and bone graft material is placed in the space between the bone and the membrane. The bone graft material may be taken from the patient’s own body, a donor, or a synthetic source.
After the bone graft material is in place, the flap of tissue is sutured back in place, and the area is allowed to heal. This process takes several months, during which the bone graft material fuses with the existing bone to create a solid foundation for a dental implant.
Osteotome Sinus Lift
The osteotome sinus lift, also known as the internal sinus lift, is a less invasive alternative to the lateral window sinus floor elevation. It involves using special instruments called osteotomes to gently elevate the floor of the sinus without creating a window in the bone.
The osteotome sinus lift begins with a small incision in the gum tissue, through which a series of specialized osteotomes are inserted. The osteotomes are then tapped gently to compress the bone and create space in the sinus cavity. Bone graft material is then placed into the space created by the osteotomes.
Because the osteotome sinus floor elevation is less invasive than the lateral window sinus lift, it often results in less discomfort and faster recovery times. However, it is not always suitable for all patients, particularly those with very little existing bone in the area.
Sinus Lift Procedure
Before the procedure, the dentist will perform a thorough examination of the mouth, including x-rays and possibly a CT scan. This will help determine the amount of bone material needed and the best location to harvest the bone graft. The dentist will also discuss the patient’s medical history and any medications they are taking, as this may affect the procedure.
On the day of the procedure, the patient will be given local anesthesia to numb the area. The dentist will make a small incision in the gum tissue near the premolars or molars, exposing the bone underneath. They will then gently lift the sinus membrane upward, creating a small space between the bone and the membrane.
Bone material is then placed into this space, either from a donor source or from the patient’s own body. The bone material may be in the form of granules, a block, or a putty-like substance. Once the bone material is in place, the gum tissue is sutured closed, and the patient is given instructions on how to care for the area during the healing process.
What conditions make people unsuitable for sinus floor elevation?
Sinus surgery may not be recommended for individuals with certain medical conditions, including:
- Cancer
- Autoimmune diseases
- Blood coagulation disorders
- AIDS
- Acute sinusitis
What are the potential complications of sinus lift surgery?
Sinus lift surgery, like any surgical procedure, carries certain risks and potential complications. It is important to have the surgery performed by a qualified and experienced dentist to minimize these risks. Some of the possible complications of sinus floor elevation surgery are:
- Perforation of the sinus membrane
- Sinus infection
- Swelling and inflammation
Perforation of the sinus membrane
If the sinus membrane is torn during the surgery, it can be repaired and the procedure can continue. In some cases, a larger tear may require time to heal.
Sinus infection
Infection is a risk with any surgery, but preventative measures such as prescribing antibiotics can reduce this risk.
Swelling and inflammation
Some swelling and bleeding from the nose and mouth are normal after bone grafting. Patients should avoid sneezing or forcefully blowing their nose to prevent dislodging the transplanted material.
Sinus Floor Elevation Recovery
The recovery period after a sinus lift can take several months. During this time, the bone material will fuse with the existing bone, creating a strong foundation for dental implants. The patient will need to avoid blowing their nose forcefully, sneezing, or any other activity that could disrupt the healing process. They may also be given antibiotics and pain medication to prevent infection and manage any discomfort.
After the recovery period, the dentist will evaluate the area to ensure that there is sufficient bone material to support a dental implant. If so, they will then place the implant into the jawbone, and the patient will be given instructions on how to care for the implant.
Post-operative care instructions after sinus lift surgery
To promote a speedy recovery after sinus lift surgery, it is crucial to follow these care instructions:
- Avoid any pressure on the surgical area, which includes refraining from sneezing or exposing yourself to allergens.
- Keep your nose moist with a saline solution to reduce swelling and nasal congestion.
- Take any prescribed painkillers and antibiotics as directed to prevent pain and infection.
- Apply an ice pack wrapped in a towel to the surgical area for 10-minute intervals during the first day after surgery, and switch to a hot water bag after 48 hours to reduce swelling.
- Avoid strenuous activities for a week and visit your dentist for a checkup around a week after the surgery.
- Drink plenty of fluids for the first 24 hours, but avoid carbonated and alcoholic drinks.
- Stick to a soft-food diet for about three days, such as noodles and eggs.
- Do not use a straw to drink liquids for several weeks.
Frequently Asked Questions
Some of the frequently asked questions are:
What should I expect after sinus lift surgery?
Sinus lift surgery is typically an outpatient procedure, meaning you can return home after the surgery. However, you may experience pain, swelling, and bleeding, which can be managed by following your dentist’s post-operative instructions.
How long after sinus lift surgery can dental implants be placed?
Full recovery after sinus floor elevation surgery takes approximately 2 to 3 months, after which the bone regains sufficient strength for dental implant placement.
What type of bone is used in sinus lift surgery?
In most cases, the patient’s own bone is used as it has living tissue and can promote faster recovery. However, synthetic products or cow bones may also be used in some cases.
How long does sinus lift surgery take?
Sinus lift surgery typically takes 1 to 2 hours to complete.
Why do I feel cheek stiffness after sinus floor elevation surgery?
Stiffness in the cheeks can be caused by infection, which can be prevented by taking antibiotics as prescribed by your dentist. If the swelling and stiffness of the cheek do not decrease after taking antibiotics, inform your dentist.
Can sinus lift and implant placement be done at the same time?
This depends on the patient’s condition and the amount of bone grafting required. In most cases, the dentist will determine that separate procedures are necessary to allow for proper healing.
Under what circumstances should sinus lift and implant placement be done separately?
Sinus lift and implant placement should not be done at the same time in cases of severe infection or inadequate bone stability for immediate implant placement, as determined by a scan review.
When should I contact my dentist after sinus lift surgery?
Contact your dentist immediately if you experience fever, increasing pain and swelling, bleeding that persists after 3 days, or if you feel bone displacement due to sneezing or coughing.
Can I fly after sinus lift surgery?
Flying after sinus lift surgery can increase pressure on the sinuses and disrupt the healing process. It is recommended to avoid flying for about a month after the surgery.
How much pain can I expect after sinus lift surgery?
During the surgery, you will be under local anesthesia, so you should not feel any pain. However, it is normal to experience pain, swelling, and inflammation for a few days after surgery. These symptoms can be managed by following your dentist’s recommendations for post-operative care.
Conclusion
Sinus lift is a safe and effective procedure for individuals who want to replace missing teeth with dental implants but have insufficient bone material in the upper jaw. The procedure involves adding bone material to the upper jaw, creating a strong foundation for dental implants. If you are considering a sinus floor elevation, it is important to speak with your dentist to determine if it is the right option for you.
