Sinus Lifts & Augmentation

Insufficient Bone and/or Poor Bone Quality

Many people opt for dental implants because they hold several important advantages over other tooth replacement methods such as traditional dentures and bridges.

Implants look, feel and work just like natural teeth and give you the best chance of maintaining your smile for life because they fuse with bone to become a permanent part of your jaw – an artificial tooth root.

However, insufficient quantity and quality of bone to stabilise a dental implant poses a problem, particularly at the back of the upper jaw, which is in close proximity to the sinus floor. A sinus lift addresses this issue by elevating the sinus floor to enable a bone graft prior to surgical insertion of implants.

Without the support of bone, implants would become loose or fall out completely. Furthermore, the sinus membranes run parallel to the upper jaw, and if the bone is too thin an implant procedure could damage these membranes.

There are several reasons you may need a sinus lift in preparation for a dental implant, including:

• The anatomy of your skull causes the back of the upper jaw to contain less bone than the lower jaw.
• Bone may have been destroyed by gum disease (periodontitis).
• Bone may have been absorbed back into the body if teeth have been missing for some time.
• Medical conditions including cancer.
• Your maxillary sinuses are too close to the upper jaw for implants to be inserted.

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. That’s why it’s 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 (laughing gas).

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.

The Sinus Lift Bone Graft

Grafting bone to the upper jaw in the area of the premolar and molar teeth is an essential part of sinus augmentation.

The bone graft fills in areas where bone is deficient or missing and acts as a supporting platform to encourage new bone growth over time, with collagen and proteins in the existing bone acting as a catalyst.

The grafted bone can come from a variety of sources. In many cases, the preferred option is to get the bone from the patient themselves (an autograft) – from another part of the mouth or from the hip or leg. This provides living tissues that helps growth and healing.

Other sources of sinus lift bone graft material include:

• Donated bone tissue when a person dies (allograft).
• Cow bone (xenograft).
• Synthetic materials such as hydroxyapatite (alloplastic graft).

All of these materials are safe and are processed and thoroughly disinfected to ensure they’re disease-free and no germs can be passed on to the recipient.

Preparing For A Sinus Lift

You’ll need X-rays or digital scans before a sinus lift so your dentist can examine the anatomy of your jaw and sinuses.

Your dental surgeon also will recommend steps you can take to prepare for a sinus lift. This advice may include:

• Quit smoking at least two weeks before the procedure.
• Stop taking any anticoagulants two weeks before surgery.
• Eat protein- and vitamin-rich foods.
• Stock up on healthy snacks for your recovery time.

After A Sinus Lift

There may be some swelling immediately after a sinus lift and bleeding from the mouth or nose. While this may be uncomfortable for a few days, most sinus lift patients don’t experience major discomfort and are back at work after two or three days.

You may be advised to take over-the-counter painkillers or given pain relief medication, and antibiotics and an antimicrobial mouthwash to protect you against infection, although infection is rare after sinus augmentation. A cold pack is also helpful in easing pain and swelling the first day or two after surgery.

Your dentist may also prescribe medicine to prevent congestion and recommend a saline spray to keep the lining of your nose lubricated.

After a sinus lift, you should contact your dental surgeon if:

• Swelling or pain worsens after a few days.
• Bleeding persists after a couple of days.
• You think you may have dislodged the bone graft by sneezing or blowing your nose.
• You get a fever.

After seven to ten days, your dentist will check on your healing progress and remove the stitches if you didn’t have dissolvable sutures.

Several more appointments may be advised during the healing process to make sure everything is going as planned.

Complete recovery after sinus augmentation takes at least six months for your sinuses to heal and the bone to become strong enough to support dental implants.

What To Avoid After A Sinus Lift?

After sinus lift surgery, you need to take measures to safeguard against the graft material moving and loosening the stitches.

You shouldn’t brush or floss the area for the first week after a sinus lift, and it’s important to be careful about what you eat for a few days:

• Choose soft foods and chew on the opposite side.
• Avoid hard or crunchy foods and hot foods.

It’s also important to try to avoid blowing your nose or sneezing forcefully for two to three weeks. A nasal spray, decongestant or other medication can help prevent this.

Avoid strenuous activity for at least a week.

Is A Sinus Lift A Good Solution For Me?

As well as the structure of your jaw, other factors will determine whether you’re suitable for a sinus lift.

You need to be in good general health. If you’ve been diagnosed with a chronic medical condition that could hinder healing, sinus augmentation may not be advisable.

Your dentist will assess your medical history and your jaw stability before deciding whether a sinus lift is right for you.

Are There Any Risks With Sinus Lifts?

Sinus augmentation is a safe and effective procedure that is performed regularly across the world.

As with any surgical procedure, there’s a risk ofinfection after a sinus lift, although this rarely happens.

Another risk is that a sinus membrane could become torn or punctured during the procedure. If this happens, your dental surgeon will stitch or patch the area. The sinus lift can often continue as planned but sometimes the membrane has to be given time to heal.

In rare cases, the existing bone may not integrate with the grafted material, necessitating a further sinus lift procedure.