A sinus lift is often performed before dental implant placement. It stretches out the whole process by a few months to ensure proper recovery and increases the cost by a couple hundred dollars. The good thing is that this procedure can make patients with bone loss candidates for the implant.
Learn more about the sinus lift process: the recovery, and what side effects you may expect.Creative Commons
What is a sinus lift?
Sinus lift (otherwise called sinus augmentation or a sinus graft) is a procedure of filling the maxillary cavity to thicken the alveolar ridge. Those cavities called sinuses are natural, hollow, air-filled spaces in your skull.
Augmentation is performed when there is significant loss of bone in the upper jaw. This means the roots of the molars often poke through into the sinus cavity. Lifts are also necessary if a patient has variation in oral anatomy, making implantation risky.
The most common causes include:
- periodontal disease,
- tooth loss,
- a birth defect or chronic condition,
- trauma or a complex extraction,
- a cyst or tumor, and
- a naturally large sinus cavity or a narrow bone ridge.
Is sinus lift for dental implants necessary?
As with bone grafting, getting implants on the top arch is the most common reason for a sinus lift. This doesn’t mean, however, that every patient needs to undergo this procedure. Sinus augmentation is needed if the jawbone has less than 3-4mm in thickness. When the alveolar ridge is too thin, implants can’t be placed.
The lift works to raise the floor of the cavity and thicken the bone that will support the new implant. It prevents perforation of the membrane during the placement surgery. Studies show that sinus grafts greatly raise the success rate as well as the longevity of the dental implant.
The sinus lift increases the time you have to wait for your implant surgery by 6-9 months. The procedure can sometimes be done on the same day under special circumstances. Each situation has to be explored individually.
Lastly, sinus lifting procedure makes the total price for dental implants higher.
Sinus lift surgery: types and procedure
There are two types of sinus lifts. The main difference for the patient is how intensely the bone needs to be volumized.
Often times greater levels of sedation are utilized to help control the patient's breathing.
Lateral sinus lift
A lateral sinus lift is also referred to as direct or internal. Specialists perform this method more often. It is used for cases in which the bone needs to be augmented more excessively.
Here is what the procedure looks like step-by-step:
- Anesthetic is administered.
- The gum is cut to expose the bone.
- A small hole is cut and the sinus membrane is pushed upwards into the cavity.
- The empty space is then filled with graft material and the gum is stitched up.
The whole surgery takes up to 2 hours, with 30 minutes on average. The next stage is the healing period, which lasts 4-12 months.
Osteotome sinus lift
An osteotome sinus lift (otherwise called indirect or external) is the less invasive option. It is used when the bone doesn’t need to be augmented too much, by less than 4mm. Patients with polyps, retention cysts, or mucosal thickening are good candidates for this method.
The procedure is carried out in the following manner:
- Anesthetic is administered.
- The gum tissue is cut open and flapped back.
- A socket is made in the bone without breaking through the membrane. About 1-2mm of the membrane is left intact.
- The sinus floor is then tapped with an instrument called an osteotome. This way it becomes lifted.
This method involves a lower risk of postoperative complications. It can also be less costly than a lateral sinus lift. The healing period lasts 4-8 months.
What to expect during sinus lift recovery?
Immediately after the procedure, your dentist will place a gauze pad to soak up the blood. You can apply gentle pressure by biting on it slightly. Rinse your mouth and change the pad every hour or so. If the site continues to bleed heavily, use an ice pack until a clot forms.
Sinus lift recovery usually lasts 3-10 days. You are likely to experience:
- moderate pain,
- facial swelling,
- bruising, as well as
- bleeding from your nose.
Do not smoke. Blow your nose as little as possible for a week. Sneezing is a big risk factor, so if you need to, do it with your mouth open. This helps alleviate pressure on your sinuses.
A check-up appointment will be scheduled to make sure the material is merging with your bone. If the stitches that were applied are not self-dissolving, they will be removed.
What are possible complications of sinus lifting?
The best way to prevent trouble is to follow post-op instructions closely. However, there is always a possibility that something might go wrong.
The most common complications after a sinus lift are:
- membrane perforation,
- graft dislocation,
- localized bleeding,
- oroantral fistula, and
- bone sequestration.
The first two are usually treated by using antibiotics. Membrane perforation, can happen during the surgery. It is important to always go with an experienced surgeon and adhere to instructions carefully.
The grafting material can move when you sneeze. If you are prone to allergies, the procedure is likely to be scheduled during a time when they are not acting up. This minimizes the risk.
Oroantral fistula is basically a blockage in the nose. Bone sequestration happens when the graft material doesn’t ossify as expected. Both of these are serious situations and should be dealt with by a professional.
If hemorrhaging, swelling, or significant pain lasts longer than two days, contact your dentist. Antibiotics or topical nasal corticosteroids might be prescribed to avoid infection and congestion. Otherwise, a check-up visit will determine whether everything is going as it should be.
Is a sinus lift painful?
Sinus lifting is not a particularly painful procedure. It is most often conducted with no more than a local injection. If you are highly sensitive to pain or if you have dental anxiety, you can ask your dentist about heavier forms of sedation.
You might feel discomfort after you leave the office. Unless your dentist prescribes stronger painkillers, OTC products should do fine to block any tenderness.
How long does a sinus lift procedure take?
The sinus lift itself takes no more than 2 hours. If you are having your implants placed at the same time, the whole thing can take up to 6 hours.
Can a sinus lift and implant be done at the same time?
Yes, if the alveolar ridge is thick enough. It commonly happens when the osteotome method is chosen. Only some patients are good candidates for this, however, so your dentist will be the one making this decision.
What are the symptoms of a sinus lift infection?
An infection makes itself apparent by significant swelling, fevering, and bleeding that lasts for longer than 10 days after the surgery. You will likely have a check-up visit during this time, so your dentist can assess whether anything went wrong.
Are there any sinus lift surgery alternatives?
Sometimes short implants can be inserted instead of the standard ones. This means less space is needed in the jawbone and sinus lifting can be forgone. This kind of tooth restoration shows a similar success rate, and often, less complications.
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