CosmognathicGeneral MedicineOral & Maxillofacial Surgery

Sinus Lift Surgery for Dental Implants

sinus lift Oral and Maxillofacial surgeons
Dr Chirag Chamria | Oral and Maxillofacial Surgeon

Sinus lift surgery, also known as sinus augmentation, is a procedure that adds bone to the upper jaw in the area of the molars and premolars. It is often performed as a preparatory step for dental implant placement when there is not enough bone height in the upper jaw to support the implants.

A sinus lift or a sinus augmentation or sinus graft; is performed by Oral and Maxillofacial surgeons. It’s suitable for patients who want dental implants for missing teeth, but do not have adequate bone to secure implants. To obtain an adequate bone in the upper jaw, a sinus lift surgery is recommended for the maxillary sinus.

The treatment procedure involves ‘augmentation or lift-up of the maxillary sinus to achieve more space for new bone formation. Hence maxillary sinuses are air-filled cavities that are located in the back portion of the maxilla.

Why is Sinus Lift Surgery Necessary?

Bone loss in the upper jaw can be caused by a number of factors, including:

  • Tooth loss: When a tooth is lost, the bone that supported it begins to resorb, or shrink. Over time, this can lead to a significant decrease in bone height.
  • Gum disease: Gum disease can also damage the bone in the upper jaw.
  • Certain medical conditions: Some medical conditions, such as osteoporosis, can also affect bone density and lead to bone loss.
    Without enough bone height, dental implants may not be able to be placed securely. This can lead to problems such as implant failure, infection, and sinus pain.

Clinical Indications of Sinus Lift:

Oro-antral Fistula: Reconstruction of palate clefts

Inter-positional graft with Lefort-1 fractures: <10mm alveolar residual bone height

<4mm residual bone width: No history of any pathology

Oral and Maxillofacial surgeons sinus lift
Sinus Lift at Royal Cosmognathic

Contraindications by Maxillofacial Surgeon:

Contraindications for sinus lift surgery can be broadly categorized into absolute and relative contraindications. Absolute contraindications are those that preclude the procedure entirely, while relative contraindications are conditions that increase the risk of complications or make the procedure less likely to be successful.

  1. Uncontrolled Systemic Disease: Patients with uncontrolled systemic diseases, such as uncontrolled diabetes, severe hypertension, or uncontrolled bleeding disorders, are at an increased risk of complications during and after surgery.
  2. Active infection in the sinus cavity: An active infection in the sinus cavity can increase the risk of spreading the infection to the bone graft material and bone surrounding the implant, leading to implant failure and potential bone loss.
  3. Previous irradiation to the maxillofacial region: Prior radiation therapy to the maxillofacial region can impair bone healing and make the procedure less successful.
  4. Inability to cooperate with the procedure: Patients unable to cooperate with the surgical procedure, such as those with severe mental health conditions or developmental disabilities, may pose a safety risk and may not be suitable candidates for sinus lift surgery.

Two Main Approaches for Maxillary Sinus Lift:

The two main approaches for maxillary sinus lift are:
1. Direct Approach- lateral window technique
2. Indirect Approach- osteotome sinus floor elevation (OSFE) technique.

  1. Lateral Window Technique

The lateral window technique is a more traditional approach that involves creating a window in the lateral wall of the maxillary sinus to access the sinus membrane. The sinus membrane is then carefully lifted, and bone graft material is placed beneath it to create more bone height for dental implants. The window is then closed with sutures or bone screws.

2. Osteotome Sinus Floor Elevation (OSFE) Technique

The osteotome sinus floor elevation (OSFE) technique is a less invasive approach that uses specialized instruments called osteotomes to gently elevate the sinus membrane. Osteotomes are blunt-tipped tools that gradually expand the space beneath the sinus membrane, creating a space for bone graft material to be placed. The OSFE technique is typically performed without the need for an incision in the lateral wall of the maxillary sinus.

Advantages of Direct technique for Sinus Lift:

  1. A Clear direct view is available
  2. Easy Access
  3. Immediate loading of implants 
  4. Efficiently worked

Disadvantages of Direct technique for Sinus Lift:

  1. More pain compared to indirect technique
  2. More post-operative discomfort
  3. Time-consuming
  4. Skill sensitive technique
  5. High risk of secondary infection.

Indirect (Osteotome): This technique is performed when the bone height is 6-8mm. Above all a crestal incision is made after which a crestal ridge is exposed.  A sharp osteotome is used to “Chisel” a rectangle in the crestal ridge of the maxilla, then a sinus-lift osteotome is used like a mallet to fracture the bone. Hence punch a hole through where the rectangle was created into the sinus floor after which the sinus is raised with bone grafting material and implants are placed.

sinus lift with bone graft
Sinus Lift Surgery – implant installation. 3D illustration

Advantages of indirect technique for sinus lift:

  1. Minimally invasive surgical procedure
  2. the osteotomy is 1-3mm in width and depth
  3. Permits a sterile environment
  4. The simple procedure doesn’t require less time or expertise

Disadvantages of Indirect technique for sinus lift:

  1. Implant to be loaded immediately within 3 months
  2. Sinus is not exposed
  3. The probability of errors is more
Dr Chirag Chamria rightly explains the procedure of dental implants with sinus lift.

However, in some cases, there may be a few complications after the surgery that one should know about:

Early complications such as:

  1. Incision line opening
  2. Bleeding
  3. Barrier membrane exposure
  4. Infraorbital nerve paresthesia
  5. Graft Loss/Failure
  6. Implant failure
  7. Oronatral Fistula
  8. Implant migration
  9. Inadequate graft lift 

Conclusion by Maxillofacial Surgeon

All these complications are manageable and can be resolved as soon as they are detected. However with proper observation and time-to-time examination of the bone augmentation process, one can achieve the desired results.

We at Royal Dental Clinics have an in-house daycare facility as well as skilled specialized dentists who perform such kinds of cases on a regular basis. Therefore, one can inquire about the same by booking an appointment and getting a consultation done where you will be explained about each and every step. So allow us to help and care about your oral hygiene and health by booking an appointment with Royal Dental Clinics.  

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1 Comment

  1. sinus lift the augmentation or lifting up of the maxillary sinus to make more room for new bone. you will not experience any pain.

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