Sinus Augmentation (Lift)
A sinus lift is a surgical procedure that raises the membrane on the floor of the sinus to create a space that can be filled with enough bone to support rear-upper-jaw dental implants. The bone is added between the jaw and the maxillary sinuses, which are located on both sides of the nose. Sinus lifts are performed on patients who need dental implants, but do not have enough bone to support them.
Types of Sinus Lifts
There are two main techniques for performing sinus lifts: the lateral window technique (LWT) and the osteotome (vertical) technique.
Lateral Window Technique
Using the lateral window technique (in what is called a "direct sinus lift"), the sinus membrane is lifted to make room for the required amount of bone, which is taken from another part of the patient's body or from a cadaver.
During the procedure, gum tissue is reflected to expose the jawbone, where a window is created into the sinus cavity. By pushing against this now-moveable piece of jaw bone (window) and moving it inward and upward into the sinus cavity, the sinus membrane is raised higher up. A bone graft is then placed into the now-empty space left behind by the raised membrane, and the area is stitched shut. Dental implants are placed 4 to 9 months later, which gives the bone graft time to mesh with the bone already there.
The least invasive type of sinus lift incorporates the osteotome approach, in which elevating the sinus is immediately followed by placement of the dental implant. The procedure begins with a small hole made in the jaw bone. Bone-grafting material is placed between the jaw bone and the sinus floor, increasing the space between them. The implant is then inserted. This technique is only appropriate in cases in which there is not enough bone to secure the implant, but enough bone to lend it some stability.
Before sinus lifts were available, upper-back tooth loss accompanied by significant bone loss meant that wearing loose-fitting dentures was a patient's only option.
After a sinus lift procedure, particularly one that uses the lateral window approach, there is some swelling. There may be some bleeding, and forceful sneezing and nose-blowing should be avoided as well as air flight. Stitches are removed after 10 to 14 days, and several follow-up visits are required to make sure the area is healing properly.
Risks of a Sinus Lift
Although a sinus lift is considered safe, it does have certain risks. They include infection, puncturing or tearing of the sinus membrane, and failure of the bone graft to integrate with the patient's bone.