A sinus lift is a procedure that aims to fill maxillary cavities, which are hollow, air-filled spaces in your skull. This is done by thickening the alveolar ridge. When it is too thin, tooth roots of molars and premolars may poke through. This can cause several issues and makes dental implant surgery impossible.
Learn more about the sinus lift process, the recovery, and what side effects you may expect.
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When is sinus lifting needed?
Otherwise called sinus augmentation or a sinus graft, lifts are necessary if a patient doesn’t have enough bone in the upper jaw. Such loss may be caused by: - 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.
The most common reason a sinus lift is performed is making dental implantation possible, similarly to bone grafting. The procedure works to fill the maxillary cavity by lifting the membrane below it. This thickens the bone that will support the 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. On the other hand, a sinus lift may delay implant surgery and make the final cost significantly higher.
Sinus lift surgery
The sinus lift itself takes no more than 2 hours, with 30 minutes on average. If you are having your implants placed at the same time, the whole thing can take up to 6 hours. This may not be possible for every patient and each situation has to be explored individually.
Often times greater levels of sedation are utilized to help control the patient's breathing.
There are two types of sinus lift procedures. The main difference for the patient is how intensely the bone needs to be volumized. Both are most often carried out under a local anesthetic. Sedation can be used if the patient suffers from low pain tolerance or dental anxiety.
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.
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.
Recovery after sinus lift procedure
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.
Full sinus lift recovery lasts at least 6 months but may take up to a year. A lateral sinus lift usually heals for longer than an osteotome one.
Symptoms of a sinus lift complication
The sinus lift success rate is just higher than 95%. Nonetheless, there is always a possibility that something might go wrong.
The most common complications after a sinus lift are: - infection, - sinusitis, - membrane perforation, - graft dislocation, - localized bleeding, - oroantral fistula, and - bone sequestration.
The first two are usually treated by using antibiotics. 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. Sinusitis makes itself apparent by swelling, a blocked nose, and pain when you bend down.
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 an opening between the sinus and the mouth that does not heal properly. Bone sequestration happens when the graft material doesn’t ossify as expected. Both of these are serious problems 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.
Exploring the sinus lift cost
The cost of a sinus lift near you may vary from office to office. A lateral sinus lift price is about $2,500. The average cost of an osteotome sinus graft is $1,500.
The fees below don’t include reductions or insurance coverage.
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Sinus augmentation is an expensive procedure. This is unfortunate, as it is usually performed to make dental implants possible, another huge hit to a patient’s budget. Complications that may arise if a patient in need doesn’t have it performed, may be even higher though.
The biggest factors determining the final quote are your location and the experience of the dentist performing the job. Larger cities have higher prices than small towns. And of course, the more experienced a dental professional is, the more they will charge.
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 4-6mm in width and 6-8mm in depth. When the alveolar ridge is too thin, implants can’t be placed.
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.
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.
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.
- Assessment of alveolar bone loss with high resolution computed tomography - PubMed
- Maxillary Sinus - ScienceDirect
- FE-analysis of dental implants with sinus lift - ResearchGate
- Direct vs. indirect sinus lift procedure: A comparison - NCBI
- Lateral Sinus Augmentation: A Simplified Safer Approach - ResearchGate
- Osteotome-Mediated Sinus Lift without Grafting Material: A Review of Literature and a Technique Proposal - NCBI
- Pain intensity and its objective determinants following implant surgery and sinus lifting: A 1-year prospective study - PubMed
- Complication Rate in 200 Consecutive Sinus Lift Procedures: Guidelines for Prevention and Treatment - ScienceDirect
- The influence of sinus membrane thickness upon membrane perforation during transcrestal sinus lift procedure - Wiley Online Library
- Accidental Displacement of Dental Implants Into Both Maxillary Sinuses During Surgery - JOI
- Osseointegration - ScienceDirect