Sinus Lifting

What is Sinus Lifting?

Sinus lifting is a surgical procedure performed when there is insufficient bone in the upper jaw to place a dental implant. This procedure involves elevating the area where the sinus cavity is located in the upper jaw, providing enough bone for the implant.

The sinuses in the upper jaw are air-filled cavities located near the nose and above the upper molars. The inside of the sinuses is lined with a thin membrane, which is lifted during the sinus lifting procedure to create space for bone grafting.

The sinus lifting procedure can be performed before or at the same time as the implant placement.

Sinus Lifting Procedure

Sinus lifting is performed when there is insufficient bone height or thickness in the upper jaw, or when the sinuses are too close to the tooth roots. This operation aims to create a strong and stable foundation for dental implants.

Dental implants integrate with the jawbone through a process called osseointegration. For a successful implant placement, there must be enough bone quantity and quality before the procedure. Sinus lifting is performed to address this deficiency.

Closed Sinus Lifting

Closed sinus lifting is a minimally invasive method, performed by creating a small opening into the sinus cavity. This method is preferred when there is minimal bone loss. In closed sinus lifting, the required bone volume for the implant is achieved by adding a small amount of bone to the existing bone. The surgery is completed more quickly, and the recovery time is faster compared to the open method.

Open Sinus Lifting

Open sinus lifting is preferred in cases of more significant bone loss and when more bone volume is needed for the implant. In this method, the gum is opened to access the sinus cavity, and a bone graft is added. Open sinus lifting requires a larger surgical intervention, so the recovery process may be slightly longer than with the closed method, but more bone can be added.

Risks of Sinus Lifting Surgery

After sinus lifting surgery, you may experience the following during the normal healing process:

• Mild pain that can be controlled with painkillers like ibuprofen or paracetamol
• Swelling, which usually peaks on the second day
• Bruising that may extend to the lower jaw
• Feeling better after the stitches are removed (about 10 days)
• Return to normal within 2-3 weeks

Immediate Issues:

• Tearing or perforation of the membrane: 19% with external approach, 3.8% with internal approach. If the membrane tears, the surgeon can stitch or patch it. If the repair is not successful, the procedure may be halted, and healing will be allowed for a few months. The second attempt has a higher success rate.
• Swelling
• Numbness due to local anesthesia
• Mild pain
• Bleeding, including nasal bleeding
• A feeling of fullness or congestion in the sinuses (temporary)
• Rare dizziness

Later Complications:

• Infection: 2.9% with external approach, 0.8% with internal approach
• Graft exposure (3%)
• Facial pain and swelling within 2-7 days
• Severe facial bruising after 1-3 days
• Insufficient bone formation (1%)
• Graft failure, especially in smokers (1.9%)

Rare Serious Complications:

• Numbness in the upper gums, cheeks, and teeth (temporary but may rarely be permanent)
• Formation of a connection between the sinus and mouth
• Removal of the graft due to long-term infection

To minimize risks:

• Use painkillers regularly
• Avoid blowing your nose for the first 2 weeks
• Inhale mentholated steam three times a day
• Do not skip antibiotics and decongestants after surgery

How Should I Prepare for a Sinus Lift Surgery?

There are some simple steps to follow before surgery:

• If the procedure will be performed with local anesthesia and sedation, you can eat and drink normally before the surgery.
• Continue taking your medications as usual.
• It is recommended to take painkillers like ibuprofen for headaches before surgery.
• Don’t forget to bring the stabilizing apparatus given by your dentist during the scan.
• Make sure to arrive on time for your appointment.

The surgery is performed under local anesthesia, and the patient remains awake. Sedation or general anesthesia is only preferred for complex surgeries or if multiple procedures are needed. The duration of the surgery varies from 45 minutes to 2 hours depending on the complexity. Antibiotics may be administered right before the procedure. As long as sedation or general anesthesia is not used, there is no need for an attendant after surgery.

Post-Sinus Lift Care

You will be examined a week after the surgery to have your stitches removed. Additionally, the dental implant treatment will be regularly monitored.

Non-Emergency Advice: If you experience the following, you should contact your surgeon. You can call 01223 216412 or email the Clinic 8 secretaries for assistance as soon as possible:

• Swelling or pain that worsens after two days
• Continued bleeding after two days
• Bright red and persistent bleeding; typically, bleeding after this procedure is slow and clots are dark red in color
• If you suspect bone material has been dislodged after sneezing or blowing your nose
• Pain does not subside over time
• Fever increases
• Feeling generally unwell

Alternative Treatments

Some common alternatives to sinus lifting include:

1. Shorter Implants: Preferred when sufficient bone is available without the need for sinus lifting. However, the shorter the implant, the higher the risk of failure. Multiple short implants may also be used, but this increases the risk of complications compared to long implants in sinus-supported areas, especially for people with strong biting habits.
2. Fewer Implants: Fewer implants are used to replace more teeth and are typically used with bridges or removable dentures anchored to the implants. While this avoids the need for a sinus lift, grafting may still be necessary in other implant sites. Fewer implants can result in more biting and chewing force, leading to more frequent complications with bridges/dentures and implants.
3. Angled Implants: Angled implants can be placed in the sinus region to avoid a sinus lift. These implants can be restored with removable dentures or fixed bridges. Five-year survival and success outcomes are evaluated similarly to conventional implants.
4. Bridges Fixed to Adjacent Teeth: Resin bridges bonded to adjacent teeth or traditional bridges involving crown reduction of adjacent teeth can be used. This option depends on the length of the gap, the condition of adjacent teeth, and the state of the tooth roots. Typically, only one or two teeth can be replaced in a bridge.
5. Dentures: If implants and bridges are not suitable, missing teeth can be replaced with removable dentures. Dentures should be removed after meals and not worn overnight.
6. Zygomatic and Pterygoid Implants: Long, angled implants placed in the facial bones behind the upper jaw. These implants are used for restoring removable dentures or fixed bridges. This method involves more complex surgery compared to traditional implant placement and may not be performed by all surgeons.
7. No Tooth Replacement: Leaving the gap as it is may be an option if there are enough functional teeth in the mouth.