The sinus lift creates extra bone for successful implant placements.
Modern dentistry now has the ability to grow bone where ever it may be needed. One of the places to increase bone thickness is the sinus cavity. This creates an improved environment for the placement of implants and the restoration of function and aesthetics. The sinus lift, sinus graft, or sinus augmentation, is a surgical procedure that “lifts” the lining membrane (called the Schneiderian membrane) upwards and grafting bone is placed below the membrane. The maxillary sinuses, on each side of the nose and in the upper arch, are chambers within the bone which have a bladder or lining just like a football. Again, the placement of the bone beneath the bladder or membrane actually “lifts” it up, hense the name “sinus lift.” Although autogenous bone (from the host) is sometimes used, it generally is synthetic bone or specially treated bone from a bone bank. The purpose is to increase the available bone height and thickness making the area conducive to receiving a dental implant. This has become a fairly common procedure. A key to implant success is the availability of adequate bone. The sinus lift procedure insures that quality and quantity of bone.
The grafted bone is used as a matrix for the host bone to grow upon. It is similar to a lattice-work which the new bone attaches to and eventually totally replaces. This creates a base of host-grown bone which is then utilized to place the implant within. The dentist recognizes that there is usually a 20% shrinkage rate and adjusts the amount of bone material grafted to make sure there is ample retention for the dental implant. This sinus lift procedure allows the patient to replace lost upper back teeth, usually the bicuspids and molars, which then have the proper function and aesthetics.
When a patient loses any tooth, the bone immediately begins to resorb, becoming shorter and thinner in width. This creates a less-than-desirable situation for an implant and tooth replacement. There may also be bone loss due to gum disease or previous surgical procedure. And sometimes the sinus itself is over-sized which results in thinner bone. The sinus may become significantly larger with time if the back teeth or lost as it may expand into the area where the roots used to be. If the sinuses expand or enlarge, there is less remaining natural bone, and this also may necessitate the need for a sinus lift.
The surgical procedure of a sinus lift involves carefully creating a “swinging door” with the hinge on the top. This swinging door is gently folded inward up under the sinus membrane. This creates a space beneath the trap door to receive the grafting bone, and this is the area into which the implant will be placed. It usually takes about six months for the host bone to replace the grafted bone into which the dentist places the implant.
There are many acceptable grafting materials. The end result is for it be compatible to the area and become a lattice-work onto which the host bone can then grow. If available, the patient’s own bone, or host bone, is used, It can be taken from another area of the mouth, the hip, the tibia, or even the knee cap. But most often human bone which is then freeze-dried, or even a and freeze-dried is used, bovine bone can be used once it is properly prepared. It is only used for the lattice-work. There are some synthetic grafting materials also available, such as perio beads and hydroxyapatite.
In some cases the dentist may elect to perform the sinus lift and place the implants at the same time. This is an acceptable treatment if there is a bone around the neck of the implant to keep it stable during the healing phase but the clinician feels that there needs to be more bone for long-term stability.
The patient is usually prescribed antibiotics and pain medication. He is told not to smoke or blow his nose, and to sneeze only with the mouth open, and not to “hold it in.” Often saline sprays are prescribed to keep the mucous lining of the nose slightly wet.
The modern dentist can now offer the restoration of not only the front teeth, but all the teeth through grafting and sinus lifts, and the placement of implants. This treatment is superior to the replacement of these teeth with loose fitting partial dentures and dentures. The sinus lift procedure including the implant ranges in cost from about $2,800 to $5,800.
Life Member of American Dental Association, Emeritus Fellow of Academy of General Dentistry, American Association of Implant Dentists