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, roots of molars and premolar teeth 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.
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. The most common reasons for this include:
periodontal disease, especially with bone 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 goal is to fill the maxillary cavity. Maxillary, or maxilla, refers to the upper jaw. The height and position of the wall below the cavity and above the ridge is altered. This procedure raises the quantity of the bone and makes room for the implant. It prevents perforation of the membrane during the placement surgery.
Studies show that maxillary 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 implant placement is happening 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.
There are two types of sinus lift procedures. The main difference for the patient is how much elevation is needed. Both techniques are most often carried out under a local anesthetic.
Sedation can be used if the patient suffers from low pain tolerance or dental anxiety. The options will be presented to you before preparation for surgery.
Lateral sinus lift
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.
An incision is made in the gum to expose the bone
A small hole is cut and the sinus membrane is pushed upwards into the cavity.
The empty area is then filled with bone graft material and the gum is stitched up.
Osteotome sinus lift
An osteotome sinus lift (otherwise called indirect or external) is the less invasive technique. It is used when the bone doesn’t need to be augmented by that big an amount, so 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:
Anesthesia 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 approach 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 maxillary sinus augmentation, your dentist will place a gauze pad to soak up the blood. You can apply gentle pressure by biting on it lightly. 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, during which you can stay home. During the healing process you are likely to experience:
bruising, as well as
bleeding from your nose.
Even though your body does most of the work, proper aftercare is an important part of this procedure.
Do not smoke while healing. Blow your nose as little as possible for a week for best results. Sneezing is a big risk factor, so if you need to, do it with your mouth open. This helps alleviate pressure on your sinuses.
You may also get a prescription for chlorhexidine mouthwash to use after the surgery. You may need some OTC pain medicine.
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 6 months at minimum 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%. If you adhere to proper aftercare, risks are minimal. Nonetheless, there is always a possibility that something might go wrong.
The most common complications after a sinus lift are:
oroantral fistula, and
The first two are usually treated by using antibiotics. An infection makes itself apparent by significant inflammation, fevering, and bleeding that lasts for longer than 10 days after the surgery.
The chances are that you have a check-up visit during this time, so your dentist can assess whether anything went wrong. A sinus infection makes itself apparent by swelling, a blocked nose, and pain when you bend down.
Membrane perforation can happen during the surgery. It is important to always go with an experienced surgeon and adhere to instructions carefully.
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.
It is possible to avoid sinus lift surgery by considering zygomatic implants.
Exploring the sinus lift cost
The costs 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.
|SINUS LIFT TYPE||AVERAGE COST||COST RANGE|
The sinus augmentation procedure is an expensive one. This is unfortunate, as it is usually performed to make dental implants possible, another huge hit to a patient’s budget. Costs to do with 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 smaller areas. And of course, the more experienced a dental professional is, the more they will charge.
Is a sinus lift for dental implants necessary?
As with bone grafting, getting teeth implants on the top arch is the most common reason for sinus lifts. This doesn’t mean, however, that there are always indications 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 as there is not enough support. Your dentist will let you know if you need bone graft or sinus lift surgeries during an initial consultation.
Is a sinus lift painful?
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 for the incisions.
You might feel discomfort after you leave the office. Unless your dentist prescribes stronger painkillers, OTC products should do fine to block any tenderness in the tissues.
Can a sinus lift and implant be done at the same time?
Are there any sinus lift surgery alternatives?
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.
You may also want to look into the option of zygomatic implants. Your dentist can let you know what's best in your case, mainly by examining X-rays of your mouth.
- 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