Sinus Lift by Dr. Raymond van Gennip
in Silver Spring, MD
Dental implants are a successful solution for damaged and/or missing teeth for the majority of patients. However, a small minority of people are refused candidacy because their sinuses are located too close to the jaw, or because they have insufficient bone height in the upper jaw, meaning that dental implants cannot be placed. A sinus lift can rectify these problems and make you a suitable candidate for the dental implants that will transform the look and function of your teeth.
What is a sinus lift?
A sinus lift is a surgical procedure that can be undertaken by an oral or maxillofacial surgeon, or by a trained and experienced periodontist. The procedure itself involves adding extra bone to your upper jaw in the area between your jaw and maxillary sinuses. This moves the sinuses further away if they are too close to the jaw, and adds bone height. However, in order to make space for the bone, it is necessary for the sinus membrane to be lifted. Some surgeons may also refer to a sinus lift as sinus augmentation instead.
When is a sinus lift necessary?
A sinus lift may be recommended for a variety of reasons. These can include:
Gum Disease Bone can be lost in severe cases of periodontal disease.
Tooth Loss After a tooth has been lost (either removed or fallen out due to damage or decay), the bone supporting it begins to be absorbed back into the body. The longer you are without a tooth, the less likely there is to be enough bone to support an implant.
Sinus Shape/Size Each of us have sinuses that are completely unique in shape and size. If your maxillary sinuses are located too close to your upper jaw bone, then it will be impossible to place the dental implants without impacting them.
Where does the extra bone come from?
Where possible, most surgeons prefer to use bone taken from another part of the patient’s body. Where your surgeon chooses to take bone from can vary from patient to patient and will be discussed at your consultation, but many opt for bone from the tibia or hip.
What happens during a sinus lift procedure?
Ahead of your procedure, your surgeon will ask you attend an imaging appointment. This will involve X-rays of your jaw, and you may also be asked to have a CT scan. These images will allow your surgeon to accurately determine the height and width of your existing bone and check the positon of your maxillary sinuses.
A sinus lift is usually performed under local anesthetic, although it may be possible to perform it under sedation. This will be discussed during your consultation.
The procedure itself involves creating a flap in the cartilage that divides the sinuses from the oral cavity, and opening a lateral window. This will allow the sinus membrane to be lifted away from your jaw. Your surgeon will then insert bone granules into the space where the sinus was previously situated. Once this has happened, the flap is closed using sutures.
How soon after a sinus lift can I have my dental implants placed?
After your sinus lift surgery, you will need to wait for the bone granules to fuse to your existing bone. This can take a number of months and generally the more bone needed to fill the gap, the longer this process will take. Therefore, most patients will find they can have their dental implants placed between four and nine months after their sinus lift.
After your surgery
After your surgery, the area around your nose and cheeks will probably be swollen, and you may experience some bleeding either from your nose or mouth. You should avoid blowing your nose and sneezing with any force as this can make bleeding worse, your sutures to become loose or for the bone granules to move out of place.
Most surgeons will provide you with a saline spray which will keep the lining of your nose moist, and you will be given a prescription for anti-inflammatory medication, anti-bacterial mouthwash and some pain relief.
After 7-10 days you will need to go back to your surgeon for him to evaluate the success of your operation and to remove any sutures that may have not yet dissolved.
Complications of Sinus Lift Surgery
There are a few complications of sinus lift surgery that you should be aware of. The main risk associated with the procedure is that the sinus membrane could be punctured or torn. If this happens, your surgeon will need to secure the tear with either a patch or sutures. In very rare cases, this may not be possible in which case it will be necessary to postpone the sinus lift until the tear has healed.
There is also some risk that the grafted bone granules do not fuse with the existing bone and develop a blood supply. If this happens, any implants that are placed into your jaw will not be successful as there will be no live bone for them to fuse to. In this instance, your surgeon may suggest that you have the sinus lift procedure repeated.
If you have been told you are an unsuitable candidate for dental implants, make an appointment with Dr. van Gennip to discuss if sinus lift surgery is a possible solution for you.