Sinus lift surgery

A sinus lift surgery for dental implants is a procedure which makes it possible to increase the volume of thinned bone tissues. The surgery resolves the atrophy problem, which is caused by the absence of permanent loading in case of missing teeth. The technique is applied on the upper jaw. It ensures secure implant anchoring and stability.

The purpose of the procedure

An upper jaw sinus lift surgery minimizes the risk of the sinuses being damaged during the insertion of artificial roots. The cavities are located above the jaw and covered with mucosa. Their bottom is positioned close to the tooth roots in the posterior region. If the tooth was lost a long time ago, the bone is not loaded and the tissue volume is decreasing gradually. The sinus edge is sinking. The height of the alveolar ridge has decreased, and it is not possible for the doctor to insert an implant and fix it securely. The solution is a sinus lift surgery following the open or closed technique.

Bone grafting is performed to restore and replace lost tissue volume by using autogenous bone. This is the patient’s biomaterial which is taken from their jaw. It is also possible to transplant artificial synthetic materials which imitate the patient’s bone. A sinus lift surgery can be performed at the same time as implant insertion.

Open sinus lift surgery

It is a complex and laborious procedure, which increases the bone volume to 12 mm. The surgeon cuts open the gum exposing the external wall of the sinus. Its integrity is not disrupted. The mucosa is shifted without being ruptured to provide space for the new bone to grow.

An open sinus lift surgery involves introducing a bone analogue replacing the patient’s cells under the internal lining of the sinus. The introduced material will gradually integrate with the jaw bone, increasing its volume, so that it will be possible to perform implantation and ensure artificial root stability.

Closed sinus lift surgery

This is a less traumatic surgery, but unlike the open procedure, this technique does not make it possible to increase volumes on a large bone section. A closed sinus lift surgery is performed by making a small opening in the future implantation zone. The sinus bottom mucosa is shifted, and then a material stimulating the patient’s bone growth is introduced. The introduced substance activates gradually, integrating with the tissue. A solid bone mass is formed after a few months.

The advantage of a closed sinus lift surgery is that it is possible to combine tissue augmentation and implant placement in one procedure. It is not applied if the bone thickness is less than 8 mm.

Price

The final cost depends on the type of the selected procedure. In addition, the sinuses should be subject to examination to identify and treat sinus diseases, which will minimize the risk of complications.

The final cost includes the cost of the surgery, anaesthesia, applying and removing stitches, and checkup examination by the doctor. The cost of the Bio Oss material and the Bio Guide membrane is also included. The amount of the material and the membrane does not affect the cost.

An Open or closed sinus lift - which is better?

In terms of the cost of different sinus lift techniques, a closed procedure costs twice cheaper, but it does not allow reconstructing the required volume on a large bone section. An open surgery is more expensive, but it gives a chance to resolve the problem of pronounced atrophy on a large upper jaw portion. The procedure can guarantee that the inserted implants will withstand the chewing load due to high stability and secure fixation.

The stages of the procedure

Before an open or closed sinus lift surgery is prescribed, the patient undergoes an examination.

At the preparatory stage:

• Consultation by the doctor: anamnesis, technique selection, bone status evaluation;
• Taking a series of tests;
• Antibacterial therapy;
• Tooth cleaning, if necessary.

Based on the examination results, an open or closed sinus lift procedure is prescribed:

• Anaesthesia and sedation.
• The gum is dissected in the implantation area and the floor is raised.
• An osteoplastic material is introduced into the cavity.
• Closed technique: inserting an artificial root; open technique: isolating the area with a membrane.
• Applying stitches.

Tissue healing takes from 7 to 14 days, and a complete integration of the material usually occurs after 1 to 4 months.

Contraindications

It is not advisable to undergo an open or closed sinus lift surgery if the following is diagnosed:

• Oncology.
• Tissue regeneration disorders.
• Diabetes.
• Cardiovascular conditions.
• Poor blood clotting.
• Low immune function.
• Mental disorders.
• Drug addiction or alcoholism.

Intervention is not advisable in case of sinus polyps, chronic rhinitis and maxillary sinusitis.

Patient’s post-operative recovery

Active tissue healing lasts for about 7 days. Full recovery will take 14 days.

During the first days:

• Up to 2 hours after the procedure - no eating, drinking or rinsing the mouth;
• After 8-9 hours - it is necessary to drink a lot of water and eat soft and warm food;
• On the second day - hygienic procedures using a soft brush; avoid exerting pressure on the operating site and the stitches;
• No physical exertion, trips or long walks;
• Take medications prescribed by the surgeon.

During the rehabilitation period (first month), it is not advisable to go scuba-diving or travel by plane. Do not eat hard food and avoid drinking with a straw. Smoking, drinking alcohol and eating very hot food are not advisable.

A sinus lift surgery is costly, so take appropriate steps to avoid complications, additional treatment and expensive procedures.

Possible consequences:

• Maxillary sinusitis - resulting from sinus damage.
• High temperature.
• Slight bleeding.
• Painful sensations.
• Oedema.
• Disruption of stitches.
• Displacement of bone material.

Strictly follow the doctor’s advice to avoid complications.

Patient’s checklist:

• Avoid abrupt movements or staying with your head positioned at an angle for a long time, as it will cause blood to intensively flush to your head. 
• Do not lift weights.
• When sneezing or blowing your nose, keep your mouth closed to prevent formation of vacuum in the mouth cavity; do not inflate your cheeks.
• Avoid catching a cold so as not to provoke rhinitis.

Minimize stressful situations during the rehabilitation period. Do not take a sauna or go to a swimming pool immediately after the intervention.

Is it possible to avoid osteoplasty?

Due to the high price and long treatment, patients are reluctant to have bone grafting done. Implantation is possible without osteoplasty if the clinical picture allows it. In this case, other techniques to insert artificial roots are used:

• Immediate implantation: an implant is inserted into the socket immediately after the damaged tooth is extracted if there is a sufficient bone volume.
• All-on-4 technique: a fixed prosthesis is placed in case of complete or partial edentulism irrespective of how much tissue has been lost. 4 artificial roots are implanted at an angle to achieve the best possible stabilization and fixation.
• Inserting super-short Straumann SLActive implants - just 4 mm!

At Axioma Dental Clinic, surgeries are performed by top-class doctors. We use state-of-the-art technologies and the best osteoplastic materials.