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Sinus Lift

sinus_lift

What Is It?


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."

What It's Used For


A sinus lift is done when there is not enough bone in the posterior of the upper 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, over time 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.

  • 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 one ages.


Preparation


Usually Dr. Roksar will pre-medicate patients with antibiotics before the surgery.

You will need X-rays taken before your sinus lift so Dr. Roksar can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan or dental-scan (cone beam scan). This scan will allow Dr. Roksar to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.

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

If you have seasonal allergies or other allergies, please notify Dr. Roksar before your surgery.

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How It's Done


Dr. Roksar can approach the sinus bone grafting in two ways. One method that is less invasive is through the extraction sight of the old teeth, known as crestal sinus graft. The second method is a full sinus lift in which the sinus is approached through the inner fold of the check. The tissue is raised, exposing the bone. A small, oval window is opened in the bone. The membrane lining the sinus on the other side of the window separates your sinus from your jaw. This membrane is gently pushed up and away from your jaw bone.

Granules of bone-graft material are then packed into the space where the sinus was. The amount of bone used will vary, but usually several millimeters of bone is added above the jaw.

Once the bone is in place, the tissue is closed with stitches. Your dental implants can be placed immediately the same day or Dr. Roksar might delay the implant placement for a few months before the dental implants are placed. This allows time for the grafted material to heal with your bone.

Follow-Up


After the procedure, you may have some swelling of the area. You may bleed from your mouth or nose. Do not blow your nose or sneeze forcefully. Either one could cause the bone-graft material to move, and loosen the stitches.

Dr. Roksar may give you saline sprays to keep the inner lining of your nose wet and prescribe medicine to prevent congestion and inflammation. You also will be given pain medicine, an antibiotic and an antimicrobial mouthwash to help prevent infection.

After a sinus lift, you need to wait several months for the bony material to harden and integrate with your jaw. Depending on the grafting material used, implants may be placed in three to nine months.

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. The FDA has approved its use during a sinus lift procedure.

Risks


The main risk of a sinus lift is infection. Patients have to do their best to comply with instructions given, especially with antibiotic treatment.

On rare occasions, the existing bone does not integrate with the bony graft material, and the grafted area does not heal properly. If this happens, any bone or implants placed in this area will have to be removed and the procedure repeated.