A sinus lift is a surgical procedure that aims to increase the bone tissue thickness under the maxillary sinus floor to prepare the area for future dental implants.
This procedure is also called sinus elevation because the surgeon will elevate the membrane of the sinus floor and then insert bone graft material in the space left between the membrane and the maxillary bone.
This is essential in patients with small amounts of maxillar bone since bone quality and quantity determine the implant’s success.
Signs you need a sinus augmentation
If you are planning on getting dental implants in the area of your upper molars, there might be chances that you need a sinus elevation with a bone graft if you have experienced the following situations:
- You have lost your upper molars prematurely.
- You have suffered from severe periodontal disease where there has been a loss of bone tissue.
- You have severe gum disease.
- You were born with facial deformities.
It is also possible to require a bone augmentation even if you are a healthy patient because on some occasions people simply have a larger maxillary sinus that extends around the roots of the upper teeth.
Now, while the sinus membrane will naturally surround the teeth roots; it won’t be viable when it comes to a dental implant since the screw insertion process will damage the membrane and the lack of bone tissue won’t provide enough support for the implant’s integration.
Benefits of getting a maxillary sinus lift
The main benefit is achieving long-term oral rehabilitation since a sinus elevation will improve your maxilla’s bone structure, allowing you to get dental implants and restore functionality and aesthetics.
Types of sinus lift procedure
There are two types of sinus lift procedures, each with its pros and cons, these are:
- Lateral Window Technique (direct sinus lift): the surgeon will make an incision in the gum and then create a small window in the bone of the lateral wall of the maxillary sinus, this piece of bone is pushed into the cavity lifting the floor of the sinus and creating the necessary space for bone graft material. The graft material is placed beneath the lifted sinus membrane and the incision site is sutured, over time, the bone grafting integrates with the surrounding bone increasing its height and thickness. This technique is preferred for patients with significant bone deficiencies.
- Osteotome Technique (indirect sinus lift): Also known as the vertical, crestal, or internal sinus lift, consists of drilling a small hole in the dental socket (the space where your natural tooth was housed) once the hole is in contact with the sinus membrane, the specialist will use an osteotome to gently push the membrane upwards unattaching it from the bone and lift it to create the space to put the bone graft. Once the bone graft is in place, the specialist will insert the dental implant and then suture the gum, leaving the bone graft and the implant to rest for a few months to allow for bone regeneration and the implant’s osseointegration. The Osteotome technique has a higher success rate, less postoperative discomfort, and faster healing times, but it’s only possible in mild to moderate bone loss cases.Â
Each sinus lift technique has advantages and is chosen based on the patient’s needs, the amount of bone needed, and the surgeon’s expertise.
Aftercare of a sinus elevation
After a sinus lift augmentation procedure, patients must follow these guidelines to ensure proper healing and minimize complications:
- Avoid Strenuous Activities: Refrain from strenuous physical activities, heavy lifting, or intense exercise for at least 1-2 weeks post-surgery. This helps prevent excessive strain and promotes healing.
- Take Prescribed Medications: Take all medications as prescribed by your dentist or oral surgeon. This may include antibiotics to prevent infection and pain relievers to manage discomfort. Follow dosage instructions carefully.
- Apply Ice Packs (if advised): If swelling occurs, apply ice packs to the affected area for 15-20 minutes at a time during the first 24-48 hours after surgery. This helps reduce swelling and discomfort.
- Avoid Touching the Surgical Site: Do not touch or disturb the surgical site with your fingers or tongue. This helps prevent infection and promotes healing.
- Maintain Oral Hygiene: Follow any specific oral hygiene instructions provided by your dentist. This typically includes gentle brushing and rinsing with an antimicrobial mouthwash, starting 24 hours after surgery.
- Avoid Smoking and Alcohol: Refrain from smoking and drinking alcohol during the initial healing period. These activities can delay healing and increase the risk of complications.
- Eat Soft Foods: Stick to a soft diet for the first few days after surgery. Avoid hard, crunchy, or spicy foods that may irritate the surgical site.
- Attend Follow-up Appointments: Keep all scheduled follow-up appointments with your dentist or oral surgeon. These visits are essential for monitoring healing progress and addressing any concerns.
- Rest and Elevate your Head: Rest as much as possible during the first few days after surgery. Keep your head elevated with pillows when lying down to help reduce swelling.
- Report Any Concerns: Contact your dentist or oral surgeon immediately if you experience excessive bleeding, severe pain that is not relieved by medication, persistent swelling or fever, or any other unusual symptoms.
Following these guidelines diligently can significantly contribute to a smooth recovery process after a sinus lift augmentation surgery.
Possible complications
Complications can include infection, fever, sinus membrane perforation, graft failure, or damage to surrounding structures. However, these are rare when performed by an experienced oral surgeon or periodontist.
Symptoms of failed sinus lift surgery
Signs and symptoms that may indicate a failed sinus lift surgery include:
- Persistent Pain: Pain that continues or worsens beyond the expected healing period (more than a few days to a week).
- Swelling: Persistent or increasing swelling around the surgical site, which may indicate unresolved inflammation or infection.
- Fever: A persistent fever may indicate an infection, which is a common complication of sinus lift surgery if not properly managed.
- Difficulty Breathing: If the sinus membrane is perforated or if there is significant swelling, it could lead to nasal congestion or difficulty breathing through the nose.
- Implant Mobility or Failure: If dental implants were placed during the sinus lift and they become loose, fail to integrate with the bone, or fail to support prosthetic teeth adequately, it could indicate a failure of the procedure.
- Sinus Infection: Symptoms such as nasal discharge, congestion, pressure in the sinuses, or a foul taste or smell in the mouth may indicate a sinus infection related to the surgery.
- Delayed Healing: If there is slow or insufficient healing of the surgical site, despite following post-operative care instructions.
- Graft Failure: In cases where the bone graft material used fails to integrate with the existing bone, it can be a sign of a failed sinus lift.
If you experience any of these symptoms following a sinus lift surgery, it is important to contact your dentist or oral surgeon promptly for evaluation and appropriate management. Early intervention can help prevent further complications and improve outcomes.
Alternatives to sinus elevation
Alternatives include shorter implants, angled implants, or zygomatic implants that bypass the need for a sinus lift in certain cases.
However, these options may not always be suitable depending on individual bone anatomy.
Sinus augmentation cost
The cost of a sinus lift varies based on factors such as location, dentist expertise, type of graft material used, and whether additional procedures are required. On average, it can range from 1.500$ to 5.000$.
Does dental insurance cover sinus lift augmentation?
Coverage depends on your dental insurance policy. While some plans may cover a portion of the procedure, most insurance companies consider it an elective procedure and don’t cover it.
Frequent Q&A
Can I get a sinus lift and a dental implant at the same time?
Yes, it’s often possible to perform a sinus lift and place implants simultaneously, depending on individual circumstances.
Can a sinus elevation cause sinus problems?
Temporary congestion or mild sinus discomfort is possible but rare, as the sinus membrane typically heals well, if you experience intense sinus problems after a sinus lift it might indicate that the sinus membrane got damaged during the procedure.
Can I fly after a sinus augmentation surgery?
Flying immediately after surgery is generally discouraged due to changes in air pressure that can affect healing.
Does a sinus lift change facial appearance?
A sinus lift is focused on the upper jaw and typically does not alter facial appearance.
Does a sinus lift hurt?
Discomfort during and after the procedure is managed with local anesthesia and pain medications as needed.
Why do I have ear pain after a maxillary sinus lift?
Ear pain can occur due to the proximity of the sinus cavity to the ears, but it should disappear as healing progresses.
Is sinus lift dangerous?
When performed by a skilled professional, sinus lifts are considered safe, with minimal risks, it’s a procedure with a high success rate.
How long does a sinus lift last?
A successful sinus lift can provide a stable foundation for implants that can last a lifetime with proper care.
Conclusion
Understanding the nuances of sinus lift augmentation surgery is crucial for anyone considering dental implants in the upper jaw.
Consultation with a qualified dental professional will provide personalized guidance on whether this procedure is right for you and what to expect throughout the process.
References
- Alshamrani A M, Mubarki M, Alsager A S, et al. (November 28, 2023) Maxillary Sinus Lift Procedures: An Overview of Current Techniques, Presurgical Evaluation, and Complications. Cureus 15(11): e49553. doi: 10.7759/cureus.49553
- Tsai, F., Pan, L., Pan, P., Chan, P., Ju, R., Wang, M., Lin, Y., & Chang, C. (2020). Comparison of 4 sinus augmentation techniques for implant placement with residual alveolar bone height ≤3 mm. Medicine, 99(46). https://doi.org/10.1097/MD.0000000000023180