Sinus Lift: Overview
A sinus lift (also called maxillary sinus augmentation or sinus floor elevation) is a surgical procedure performed to prepare dental implants. To understand how a sinus lift works, you need to know a little about the anatomy of the sinuses.
The sinuses are empty, air-filled spaces in the skull that serve several functions, including reducing the weight of the skull. There are four pairs of sinuses. The largest are the maxillary sinuses, located below your eyes and next to either side of your nose. Some of your upper teeth have roots that can extend all the way to the bottom of the maxillary sinuses.
Dental implants need bone to hold them in place. If the bone on the floor of the maxillary sinus is too thin, it may need to be augmented before dental implants are placed. This is accomplished through a surgical procedure called a sinus lift.
This article will cover who might be eligible for a sinus lift, how a sinus lift is performed, and what to expect before and after surgery.
What is a Sinus Lift?
A sinus lift involves grafting bone into the floor of the maxillary sinus so that dental implants can be attached. This is done when dental implants are needed to replace lost teeth (usually in adults) and the bone in that area has atrophied (become thin or weak) due to periodontal (gum) disease , tooth loss or other conditions.
A sinus lift is usually performed by an oral surgeon or periodontist on a scheduled outpatient basis with local anesthesia. The bone used in a sinus lift can be:
- Autogenous: Bone comes from your own body (often taken from other places in your mouth).
- allogenic: The bone is from a corpse.
- Xenograft: The bone is from a non-human animal, such as a cow (bovine).
- Synthetic: A bone substitute can be used, often with bone.
Various surgical techniques
A sinus lift can be performed by open or closed techniques.
open sinus lift
A sinus lift involves going through your mouth and making an incision in the gum line to expose the jawbone. A circle of bone is cut out and lifted into the sinus cavity. The remaining space is then filled with bone graft and the incision is closed.
After approximately four to 12 months of healing, a dental implant can then be placed in this area. The open sinus lift is the most commonly used surgical technique.
Most people are suitable for open sinus lifts because they can be performed if a person has less than 4 millimeters of residual bone height. Another advantage, this technique allows the surgeon to visualize all the structures on which he is working. A major drawback is the number of incisions.
closed sinus lift
During a closed sinus lift, no incision is made in the gums. The entire procedure is performed through a single hole into which the dental implant will eventually be inserted. A closed sinus lift can only be performed if your residual bone height is at least 4 to 5 millimeters.
The benefits of a closed sinus lift include fewer incisions, reduced surgical time, and the possibility that the implant can be placed immediately after your sinus lift. A major drawback of this surgical technique is that the surgeon cannot directly visualize the structures he is manipulating.
Not everyone is a good candidate for a sinus lift, including:
- People undergoing certain types of cancer treatment
- People with uncontrolled diabetes
- Some people with allergic rhinitis or chronic sinusitis
- People who smoke and can’t quit
- People with alcohol use disorders
Some of the risks vary depending on the type of procedure.
open sinus lift
The risks of an open sinus lift include:
- Accidental displacement of the bone graft (may occur during violent sneezing or blowing your nose too hard)
- Failure of bone graft to develop adequate blood supply (rare)
- Sinusitis (inflammation of the sinuses)
- Perforation of the sinus membrane (this risk is increased in smokers)
closed sinus lift
The risks of a closed sinus lift include:
How to prepare for a sinus lift
Your healthcare provider will give you specific instructions on how to prepare for a sinus lift. Follow them exactly.
These instructions may include stopping certain medications for a while, such as aspirin, which may increase your risk of bleeding during the procedure. Instructions may also discuss obtaining clearance from your insurance provider, arranging transportation, and planning time off to recover.
Before your procedure, your healthcare provider will likely order x-rays or a special type of computed tomography (CT) called cone-beam computed tomography (CBCT). This helps them better visualize your jawbone and sinuses to plan surgery and better identify individual risks of surgery.
Most sinus lifts are performed under local anesthesia. However, if you are to receive general anesthesia or a sedative, you will be asked to stop eating and drinking for a certain period before surgery.
Some health care providers may prescribe medications to be taken shortly before surgery (like an antibiotic). If so, be sure to follow these instructions to the letter.
What to expect on the day of surgery
While your experience may vary slightly depending on your situation and the preferences of your healthcare provider, generally speaking most people can expect what follows on the day of their sinus lift.
You will likely be asked to fill out paperwork and answer a few questions when you arrive for your appointment. Questions may include drug allergies, your general health, medications you have used recently, and the last time you ate or drank anything.
You may be asked to remove your contact lenses, metal jewelry or dental appliances. Your blood pressure and other vital signs can be taken, and you can be hooked up to machines that monitor your vital signs.
You will be given local anesthesia, which will numb the area of surgery and minimize discomfort. Local anesthesia usually lasts several hours.
Some people are also given a sedative. If you are being sedated or under general anesthesia for your surgery, you will not be allowed to go home after your procedure. In this case, be sure to ask someone else to drive you home.
After surgery, you may be monitored for a short time. Before you are discharged, you should receive verbal and written instructions on how to care for yourself at home, including any warning signs you may need to tell your surgeon.
You may be sent home with multiple prescriptions. Medications commonly prescribed and recommended after a sinus lift include antibiotics, decongestants (such as oxymetazoline), antimicrobial mouthwashes, saline nasal spray, and pain relievers, which may be prescription or over-the-counter (OTC). ).
It’s not uncommon to have nose or mouth bleeds right after surgery, and you can expect some swelling. Your health care provider may ask you to use ice packs to reduce swelling. You will likely need to keep your head elevated while you sleep for a few nights to help.
Some people may have bruising around the surgical site. Make sure you know how much bleeding and swelling is too much and when you need to let your surgeon know. Carrying heavy loads or strenuous activities can increase bleeding. Your health care provider should give you instructions on specific activities to avoid.
You will likely need to follow a special diet for a short time after your sinus lift. Generally, you can start drinking liquids and then move on to soft foods. You may need to avoid foods and drinks that are carbonated or acidic and prone to burning (such as lemonade or tomato juice).
Pain after a sinus lift is usually minimal, and you may only need over-the-counter pain relievers such as Tylenol (acetaminophen) and Advil or Motrin (ibuprofen). If your health care provider has prescribed prescription pain relievers, it is important that you use them only as prescribed.
After your surgery, you must be careful not to sneeze or blow your nose to avoid dislodging your bone graft. Although you cannot necessarily avoid sneezing, it is recommended to sneeze with your mouth open.
Some health care providers recommend that you avoid drinking through straws and major elevation changes and activities such as scuba diving for some time. This is because these activities affect the pressure in your sinuses.
Your healthcare provider will likely want to see you for a follow-up appointment about a week after your surgery to check on your progress and make sure your recovery is going well.
Sinus lift or additional bone grafts
It is not uncommon for additional bone grafts or sinus lifts to be performed, particularly if a large amount of bone was needed to fill a bone defect.
Although every individual is different, a sinus lift takes about six months to fully heal, after which you may be ready for dental implants. No long term care should be needed related to the actual sinus lift after healing.
A sinus lift is a common surgical procedure in preparation for the insertion of a dental implant. People who are undergoing certain cancer treatments, who have uncontrolled diabetes, or who cannot quit smoking may not be good candidates for a sinus lift.
A sinus lift is performed as part of day surgery and usually under local anesthesia. Although uncommon, risks may include bone graft failure, sinusitis, or sinus membrane perforation.
A word from Verywell
A sinus lift can greatly improve your chances of a successful dental implant procedure. Follow your health care provider’s instructions carefully. The information in this article can also give you a general overview of the procedure and what many people can expect.