Sinus lift

What Is Sinus Lift?

Sinus lift is an English term and stands for sinus floor elevation. In dentistry, it is a special procedure for bone augmentation in the maxilla and used when the available bone is reduced due to bone resorption to an extent that dental implants cannot be inserted stably. In this procedure, the bony floor of the maxillary sinus is thickened to gain volume, which can be used as a basis for implant anchorage.

When Is Sinus Lift Necessary?

If dental implants are necessary enough bone volume for anchoring must be available. If the existing bone substance is not sufficient, the implant cannot be placed without a sinus lift, because most of the implant would be in the air-filled maxillary sinus instead of being anchored in the bone.

Procedure of Sinus Lift Surgery

The sinus lift is carried out under local anesthesia, since general anesthesia is not necessary in most cases. An internal or an external access can be used for sinus lift.

Internal Sinus Lift

Internal access is carried out in case of a slight height deficit of the jawbone. If only a few millimeters of bone substance have to be added, this minimal invasive procedure is preferred for a slight elevation of the maxillary sinus floor. The access to the maxillary sinus is made through the same channel as the later implant. After the surgery, a healing time of about 8 months can be expected. Not before then, can the anchored implant be further treated and the work on the dentures be started.

External Sinus Lift

The external sinus lift is complex and used when more than three millimeters of bone height must be added. First the gums are opened and the wall of the maxillary sinus is exposed on the outside. This so-called bone window is prepared up to the floor of the maxillary sinus. Then the bone is pushed upwards and, as in the case of an internal sinus lift, the artificially created cavity between the sinus floor and the bone is filled with bone replacement material. If a bone height of at least 3-5mm are added, the implant can be anchored at the same time as the bone resorption.

What Has to be Paid Attention to After Sinus Lift Surgery?

After a sinus lift surgery, the treated area should be spared. Increased pressure caused by blowing the nose should be avoided. Instead, the affected person must be satisfied with nose swabbing for the first week after the surgery. When brushing teeth, the affected area should be left out. In order to ensure that some cleansing takes place anyway, a special mouthwash is prescribed to bridge the gap. Alcohol and nicotine impair the healing of the wound and should therefore not be consumed after the surgery. Major physical exertion such as heavy lifting or sports should also be avoided in the first week. The local anesthesia usually lasts for a few hours after the surgery. During this time, it is difficult to eat or drink, as you may accidentally bite your tongue or cheek.

In many cases swelling may occur. The remedy is cooling by placing a cool pack wrapped in kitchen towel. In rare cases it can come to secondary bleeding. A clean cloth or cotton wool pad should be pressed on the spot in an upright sitting position to apply compression.

Risks And Possible Complications

Despite all the progress in dentistry, a surgical intervention is always associated with certain risks. The formation of a hole in the sinus floor can lead to an opening of the maxillary sinus with subsequent material displacement. This can lead to chronic inflammation, bleeding, or infection. The general complications of an invasive procedure on the human body include

• Wound infection
• Postoperative swelling
• Hemorrhage and secondary bleeding
• Postoperative pain
• Injury to neighboring structures, e.g. nerves

Which doctors are specialists for a sinus lift?

The surgical procedure of a sinus lift is carried out by oral surgeons. In many cases, the dentists carrying out the surgery also have an additional qualification in implantology. Besides, the sinus lift is carried out by oral and maxillofacial surgeons. These are doctors who have both a medical degree and a degree in dentistry and have completed a five-year specialist training course.

Sources:

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• A. Stuck et al.: S2k-Leitlinie Rhinosinusitis. Deutsche Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie (DGHNOKHC). Stand März 2011.
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