In some patients, when we look at our X-rays and CT scan to plot the location of dental implants on the upper jaw, we find there isn’t enough bone in the upper jaw, or else the sinuses are too close to the jaw to allow for implants to be placed. We need to add bone to the upper jaw; this process is called a sinus lift.
Rather than sending you to a periodontist, we perform this procedure in-house at Clear Lake Dental Care.
What is a sinus lift?
A sinus lift is a surgical procedure that involves adding bone to the upper jaw, usually in the area of the molars Patients often need a sinus lift in order to make room in their mouth for dental implants. Sometimes called a sinus augmentation, this procedure adds bone between the upper jaw and the maxillary sinuses, underneath your sinus cavities, which are located on either side of your nose. When this bone is added, your sinus cavity must be moved upward to make sure that your jaw and sinuses aren’t too close together.
Why is a sinus lift needed?
There are many reasons you may need to have bone added to your upper jaw. Some of the cases where you would need a sinus lift include:
- If you have lost teeth and are in need of dental implants. Before you can have your implants placed, the back of your jaw by your molars may need to have bone added so the implants can be placed. Generally, the back of your mouth has less bone than the front of your mouth, and that is why you may need bone added there.
- When too much bone is lost after having a periodontal disease to support implants. If periodontal disease is allowed to run rampant to the point where you’ve lost teeth, you will lose the bone that once surrounded your teeth. Patients will need to have bone added if they have lost too much bone.
- If your sinus cavity is too close to your upper jaw. If you need implants placed but your upper jaw is too close to your sinus cavity, you will need to have a sinus lift. This will vary from person to person depending on the size of their sinus cavity.
What does a sinus lift do?
The problem is bone mass. If you’ve lost bone mass in the upper jaw, whether due to jawbone resorption caused by a missing tooth or gum disease, there may no longer be enough bone to adequately anchor a dental implant. This can also be a case of simple anatomy, where the patient’s sinuses are too close to their upper jaw. In some cases, the bottom of the sinus cavity can be just a couple millimeters above the tooth roots. While dental implants have a ridiculously high success rate, in the 95 percent range, if they do fail it is usually because they were placed into an area of the jaw where there wasn’t enough bone mass. A sinus lift provides sufficient bone to place the implant.
How is a sinus lift done?
The first step in this procedure is to get the bone that will be used for the graft. This can come from the patient’s body, from a cadaver, or from cow bone. All of these options are good sources.
We also take X-rays and CT scans to study the anatomy of the patient’s jaw and sinuses. This gives us an idea of how much new bone we need, in effect how much we’ll want to “lift” the sinus.
To start the procedure, we make an incision into the gum where the implant is planned. This exposes the jawbone. Then a moveable flap is cut through the jawbone into the sinus cavity. This flap is pressed gently upward into the sinus cavity, “lifting” the sinus membrane. This “lift” now has created empty space in the bottom of the sinus cavity that can be filled with bone graft material. To be sure enough mass is added, usually several millimeters of bone is added above the jaw.
Once the bone graft material is in place, the gum tissue is closed with stitches. This ends the procedure. Now the bone graft has to get to work building the new jawbone mass. After between four and nine months, the bone graft will have fully meshed and become a part of the jawbone. Now there is sufficient mass to place the implant.
Sinus Augmentation Recovery
After your sinus lift, you will have some swelling. There may be bleeding from your mouth or nose, but not large amounts. You can’t blow your nose and must not sneeze, as this can cause the bone-graft material to move and your stitches to loosen.We’ll give you saline sprays to keep the inner lining of your nose wet. We’ll also prescribe medicine to prevent inflammation and congestion, along with an antibiotic and an antimicrobial mouthwash to prevent infection.
There isn’t much pain, but there will be bruising. Bruising will start in your cheeks and will likely descend. It can look extreme, but it is normal. It may take up to two weeks for this to resolve.
You’ll come back in after 7-10 days so we can see how things look. If we didn’t use dissolvable stitches, your stitches will be removed now. From there, we’ll see you only periodically to check on the progress of the bone graft.
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How does a sinus lift compare to a bone graft?
In some cases where a patient has lost some bone mass due to a tooth being gone for a period of time or due to gum disease, there can be a question of jawbone mass. To be safe, it’s a good idea to add jawbone mass through a bone graft. The difference between the sinus lift procedure described above and a bone graft is basically the placement. In the lower jaw and the forward area of the upper jaw, the sinus cavities do not come into play when dealing with bone mass. So, there is no need to “lift” the sinus membrane, as in a sinus lift. Instead, once the gum tissue has been pulled back exposing the jawbone, bone grafting material can be placed directly into the location of the former tooth root and the gum tissue stitched back down. The bone graft will then mesh with the bone, adding mass.
Is a sinus lift painful?
You don’t feel a thing during this procedure. Afterwards, there is only a little discomfort. You’ll have pain medication, but many patients find over-the-counter pain medication to be sufficient.
Risks of a Sinus Lift
The main risk with a sinus lift is that the sinus membrane could be punctured or torn when the jawbone flap is being lifted to push back the membrane. This tear can be stitched closed or patched, but this may cause the procedure to be postponed to allow the membrane hole time to heal.
Infection is a risk with any surgery, but this is rare after sinus lifts.
On rare occasions, the existing bone and the bone graft material don’t mesh. This prevents the grafted area from developing a blood supply. If this happens, any implants placed into this “bone” will fail because the grafted jawbone failed. If this happens, the sinus lift procedure can be repeated.
Sinus Lifts at Clear Lake Dental Care
At many dental practices, they will tell you that you need a sinus lift and then proceed to send you to another dental practice to have the sinus lift performed. This is an inconvenience that you do not need to suffer through. At Clear Lake Dental Care, we perform sinus lifts in our office, right where you get your cleanings and other procedures. Once we tell you that you will need a sinus lift, you can make your appointment immediately. You won’t have to deal with any outside practices; you will have the procedure done at a practice that you trust.