When May a Sinus Lift Be Necessary?
When planning an implant in the posterior region of the upper jaw, the obstacle most often encountered is insufficient bone height. The reason is that above the tooth lies an air space called the maxillary sinus, and that after tooth loss the bone in that area reduces over time. Elevating the sinus floor (a sinus lift) is a procedure that aims to increase bone volume so that the implant can be placed safely.
Why does bone reduce in this area?
After a tooth is extracted, the bone in that area resorbs over time because the chewing load it used to carry has gone. In the posterior upper jaw the sinus cavity may also expand downwards. When the two factors combine, the height needed for an implant may no longer be there. The time that has passed since the tooth was lost therefore matters.
How is the decision made?
The decision is not made by looking at a panoramic radiograph alone. Remaining bone height and width and the shape of the sinus floor are assessed with three-dimensional imaging that allows cross-sectional measurement. Whether the sinus is healthy is also checked; if there is active sinusitis the procedure is postponed and that condition is addressed first.
| What is assessed | Why it matters |
|---|---|
| Remaining bone height | Determines the choice of method and whether the procedure can be carried out at the same appointment as the implant |
| Bone width | Even where height is sufficient, an additional procedure may be needed if width is not |
| Anatomy of the sinus floor | Septa and irregularities change the surgical plan |
| Sinus health | If there is active infection or chronic sinusitis, the timing changes |
| General health and smoking | Affect healing and the outcome |
Two basic approaches
The closed method (crestal approach). The sinus floor is pushed upwards in a controlled way through the socket in which the implant will be placed. It may be preferred where the remaining bone height is above a certain level and the primary stability of the implant can be achieved. It is usually carried out at the same appointment as the implant.
The open method (lateral window). A window is made in the bone from the side, the sinus membrane is lifted and graft material is placed in the space created. It is used where there is less remaining bone or where a wide area is needed. The implant may be placed at the same appointment, or the graft may be left to mature.
Which method is used is determined by the measurements; neither is superior to the other. For where this procedure sits within oral surgery, see the Oral Surgery Procedures page.
The healing period
Swelling and tenderness lasting a few days can be expected after the procedure. During this period you should not blow your nose forcefully, should keep your mouth open when sneezing, should not use a straw, and should postpone situations involving pressure changes such as air travel for as long as your dentist advises. Not smoking is particularly emphasised.
Slight blood-stained discharge from the nose may occur in the first days. With increasing pain, high fever, a bad smell, persistent one-sided nasal blockage or discharge from the surgical site, you should contact the clinic.
Are there alternatives?
A sinus lift is not the only route in every case. Depending on the remaining bone, options such as using shorter implants, placing the implant at an angle, taking support from a neighbouring area, or a partial denture instead of a fixed prosthesis may be considered. Each option has its own conditions and limits; the decision is made together with the measurements and the prosthetic plan.
Frequently asked questions
Is a sinus lift a painful procedure?
The procedure is carried out under local anaesthesia. Swelling and tenderness lasting a few days can be expected afterwards; the aim is that these remain at a controllable level.
When is the implant placed after the procedure?
If the remaining bone is sufficient, it can be placed at the same appointment. If not, a period is allowed for the graft to mature; this varies according to the individual and the material used.
I have sinusitis — can the procedure be carried out?
Not while there is active infection. That condition is addressed first and the sinus is allowed to become healthy.
What graft material is used?
Bone taken from the person, ready-made bone grafts, or a combination of these may be used. Which material will be used and why is explained to you; you are entitled to ask.
What happens if the procedure is unsuccessful?
Though uncommon, a tear in the membrane, infection, or the graft failing to mature as expected can occur. In such cases waiting, re-assessment or a different prosthetic plan are discussed.
At our clinic at the Beylikdüzü–Esenyurt junction, the decision on sinus floor elevation is made by assessing three-dimensional measurements, sinus health and the prosthetic plan together.
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