Bone Grafting
A sinus lift, also called sinus augmentation or sinus floor elevation, is a bone grafting procedure that adds bone to the upper jaw above the back teeth so a dental implant has enough bone to anchor in. The surgeon gently lifts the thin membrane lining the floor of the maxillary sinus and places bone graft material underneath. Implants are placed at the same visit or after the graft heals, usually over several months.
Key takeaways
- A sinus lift is needed when there is not enough bone height under the sinus to hold an implant in the upper back jaw.
- Bone loss here is common after back teeth are lost, because the sinus expands and the jawbone shrinks.
- Recovery is usually similar to a tooth extraction, with extra care to protect the sinus: no nose blowing and sneezing with the mouth open.
- 3D cone beam CT imaging is used to measure bone height and plan the procedure.
Why The Upper Back Jaw Often Lacks Bone
The maxillary sinuses are air-filled spaces behind your cheekbones, directly above the roots of the upper premolars and molars. When those teeth are lost, two things tend to happen: the jawbone that supported the roots begins to resorb, and the sinus floor can drop into the space. The result is sometimes only a thin layer of bone between the mouth and the sinus, too little to hold an implant securely.
Periodontal (gum) disease, long-term denture wear, and injuries can also reduce bone in this area. Learn more about the causes in reasons for jawbone loss.
Who Is A Candidate For A Sinus Lift?
You may need a sinus lift if you:
- Are missing one or more upper back teeth and want dental implants
- Have lost bone in the upper back jaw from gum disease, infection, or long-term tooth loss
- Are missing most upper teeth and need implant support for a fixed bridge or denture
Candidacy is confirmed with 3D cone beam CT imaging, which shows the bone height and width, the sinus anatomy, and the health of the sinus lining. Active sinus disease, uncontrolled medical conditions, and heavy smoking may need to be addressed first.
Two Main Sinus Lift Techniques
| Crestal (internal) sinus lift | Lateral window sinus lift | |
|---|---|---|
| When used | Some bone is present, but not quite enough height | Bone height is very limited |
| Access | Through the implant site in the jawbone | Through a small window in the side wall of the upper jaw |
| Implant timing | Often placed at the same visit | Same visit or after healing, depending on bone available |
| Typical swelling | Mild | Moderate, sometimes with bruising |
Your surgeon chooses the approach based on your imaging and the number of implants planned. The graft material may be your own bone, donor bone, or a bone substitute; each option is explained at the consultation. See about bone grafting for an overview of graft types.
How Long Does A Sinus Lift Take To Heal?
The soft tissue heals within one to two weeks. The graft takes longer to mature into bone that can support an implant. When implants are placed after the graft, healing typically takes several months, commonly in the range of four to nine months. When there is enough starting bone, the implant may be placed at the same time, which shortens overall treatment. A systematic review of sinus floor elevation found high implant survival rates, particularly with modern rough-surfaced implants.
Sinus floor elevation with implants is "a predictable treatment method showing high implant survival rates and low incidences of surgical complications." — Pjetursson et al., Journal of Clinical Periodontology, 2008
Recovery: What To Expect And How To Protect The Sinus
Most patients describe recovery as similar to having a tooth removed. You may have some swelling, bruising of the cheek, mild nosebleeds, or congestion for a few days.
For about two weeks, or as long as your instructions say:
- Do not blow your nose. Wipe it gently instead.
- Sneeze with your mouth open to avoid pressure in the sinus.
- Do not use straws, and avoid smoking.
- Avoid heavy lifting, bending, and strenuous exercise for the first few days.
- Avoid flying or scuba diving until the surgeon says it is safe.
- Take any prescribed medications, such as antibiotics or decongestants, exactly as directed.
Call the office if you notice bleeding that will not stop, increasing swelling or pain after day 3, fever, graft granules coming from the nose, or fluids passing from your mouth into your nose.
Sinus Lift And Your Implant Plan
A sinus lift is one step in a larger plan. Your surgeon and restorative dentist coordinate implant placement, healing time, and the final crown or bridge. Read more on dental implants, bone grafting before implants, and what affects the cost of dental implants in Ontario.
Sinus Lifts And Implants In Waterloo, Kitchener, And Cambridge
Our office at 96 Union Street East in Waterloo provides sinus lifts, bone grafting, and implant placement for patients from Waterloo, Kitchener, Cambridge, Guelph, and Stratford, with in-office 3D CBCT imaging to measure the bone under the sinus before surgery. We work alongside your own dentist, who completes the final crown or bridge. Call +1 (519)-743-7811 or ask your dentist to send a referral.
Sources
- Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Journal of Clinical Periodontology, 2008.
- Sinus lift, Dr. Kevin J. McCann Oral & Maxillofacial Surgery.
FAQ
Is A Sinus Lift Painful?
The procedure is done with local anesthetic, and IV sedation is available. Afterward, most patients have discomfort similar to a tooth extraction that is managed with prescribed or recommended pain medication and improves over a few days.
How Long After A Sinus Lift Can I Get An Implant?
If the implant is not placed at the same visit, it is usually placed after the graft has healed, commonly after four to nine months. Your surgeon confirms readiness with an examination and imaging.
Can I Blow My Nose After A Sinus Lift?
No. Avoid blowing your nose for about two weeks, or as your instructions say, because pressure can disturb the graft and the sinus membrane. Sneeze with your mouth open.
What Are The Risks Of A Sinus Lift?
Possible risks include tearing of the sinus membrane, sinus infection, bleeding, and graft failure. Your surgeon reviews your imaging and medical history to reduce these risks and explains them before treatment.
Is There An Alternative To A Sinus Lift?
Depending on your anatomy, alternatives may include shorter implants, angled implants that avoid the sinus, a tooth-supported bridge, or a removable prosthesis. The best option depends on your bone, bite, and goals.
This article is general patient education and does not replace an examination, diagnosis, or the written instructions from your own surgeon or dentist. If you have heavy bleeding, trouble breathing or swallowing, or rapidly spreading swelling, call the office or go to the nearest emergency department.