Plastic Surgery

Sinus-lift surgery

What is the Sinus-lift surgery?

A sinus lift is surgery that adds bone to your upper jaw in the area of your molars and premolars. It's sometimes called a sinus augmentation. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose.

To make room for the bone, the sinus membrane has to be moved upward, or "lifted." A sinus lift usually is done by a specialist. This could be either an oral and maxillofacial surgeon or a periodontist.

The bone used in a sinus lift may come from your own body (autogenous bone) or from a cadaver (allogeneic bone).

If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth or body. In some cases, the surgeon removes bone from your hip or tibia (the bone beneath the knee).

When Sinus-lift is done?

A sinus lift is done when there is not enough bone in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed. There are several reasons for this:

-  many people who have lost teeth in their upper jaw - particularly the back teeth, or molars - do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw;
-  bone may have been lost because of periodontal (gum) disease;
-  tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants;
-  the maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus varies from person to person. The sinus also can get larger as you age.

What is the procedure?

During the procedure, the mucous membrane of the maxillary sinus is lifted through a small window and bone substitute material is inserted between the mucous membrane of the maxillary sinus and the remaining bone. Depending on the bone substitute material used, the foreign substance should turn into bone within 4-8 months.

A distinction is made between an internal and an external sinus lift. In an internal sinus lift, the mucous membrane of the maxillary sinus is prepared through the implant’s drill hole. The cavity created is then inserted with bone material. The maxillary sinus’ intact mucous membrane prevents the bone material from getting into the maxillary sinus from the top. The internal sinus lift is particularly suitable if just a few teeth need to be replaced.

The external sinus lift is particularly suitable if a number of teeth need to be replaced and there is very little bone left to work with. In this case, a small lateral window to the maxillary sinus is created. The bone substitute material is inserted through this window. A reconditioning of the bone substitute material with autologous body cells or growth factors is not necessary.

Some specialists have started using proteins called growth factors to help the new bone harden faster. Platelet-rich plasma, which contains the growth factors, is taken from your blood before surgery and mixed with the graft that is placed into your sinus. Human-recombinant bone morphogenetic protein is an engineered protein that is now available. It stimulates bone formation without grafting.

Recovery period and recommendations

Possible side effects and complications

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