Sinus lifting?

A sinus lift is a surgical procedure that increases the bone mass in the back of the jaw, where the molars are located. When the position and thickness of the maxillary sinuses do not allow implants to be fixed, this solution is used to increase the amount of bone tissue that will support the dental implant.

What is the maxillary sinus? The maxillary sinus is a cavity inside the jawbone, lined with a breathable mucous membrane. When side teeth are lost, due to air pressure inside the sinus, it increases in volume and occupies the space left open in the bone by the loss of the tooth.

About sinus lift surgical procedure

When you want to insert an implant in this place it is no longer possible because of this air-filled cavity. What can be done? In order to be able to insert an implant in these places, an operation called sinus lift can be performed, which means lifting the sinus membrane upwards to its position before extraction and adding bone so as to increase the amount of bone present under the sinus membrane and make it possible to insert an implant.

The implants can be inserted at the same time as the sinus lift operation or at a later operative time, this decision being made by the specialist following analysis of a CT scan.

The duration of the operation varies depending on the complexity or whether or not implants are inserted in the same treatment session, from 30 minutes to 1 hour.

Waiting time after sinus lift is 6-8 months.

Our specialist's recommendation is to consult a prosthetist as soon as possible after the extraction of an upper jawbone to have the empty space filled in. Otherwise the maxillary sinus will enlarge at the expense of the bone and the possibility of inserting an implant without a sinus lift is greatly reduced.

What is sinus lift surgery?

Before treatment, mandatory investigations such as a panoramic X-ray and a CT scan are carried out, which will show the exact structure and density of the bone. Sinus membrane elevation can be done in two ways, internally or externally.

Sinus lift or sinus lift is a surgical procedure required in patients with insufficient bone structure prior to dental implant to ensure long-term implant acceptance and success. The sinus lift is performed by the dental surgeon and consists of adding bone between the jaw and maxillary sinuses and moving the sinus membrane higher (lift), most commonly through the side walls of the maxillary sinus.

There are two types of sinus lift procedures - closed and open. It is the doctor who decides, after taking and viewing the panoramic X-ray, which type of procedure the patient needs depending on the volume of bone present.

Types of sinus lift

Sinus lift closed (internal)

Closed or internal sinus lift is performed in mild cases when the sinus does not need to be lifted very much and the bone tissue is at least 10mm. In this situation, the sinus lift procedure can be performed in the same session as the dental implant insertion procedure. For a closed sinus lift, a minimum of 1-2mm bone addition is needed.

When is internal sinus lift surgery recommended? Internal sinus lift is especially recommended when only a few teeth need to be replaced. It is performed in the area of the premolars and molars, at ridge level: a path is created to the maxillary sinus, then by carefully pushing the sinus membrane, the bone substitute is inserted to create a height and width appropriate for the support of the necessary dental implant. This procedure is performed when there is a relatively sufficient amount of alveolar bone and only 1-2 millimetres of bone addition is required.

What are the stages of internal sinus lifting?

  • local anaesthesia
  • incision of the mucosa and removal of the mucosa with exposure of the jaw bone
  • perforation of the bone until the sinus membrane is reached
  • detaching the sinus membrane with special instruments and introducing the mixture of bone and blood into the space between the sinus membrane and the jawbone, resulting in the lifting of the membrane (sinus lift).

Advantages of internal sinus lift?

It has been clinically proven that sinus lifts allow for the insertion of longer dental implants, which are therefore more durable and last longer. The procedure is extremely delicate, requiring a high degree of experience and dexterity on the part of the surgeon.

Disadvantages of internal sinus lift?

The disadvantage of this type of surgery is that it is a "blind" manoeuvre, with no visual control, the surgeon relying practically only on the sense of touch to elevate the sinus membrane.

Sinus lift open (external)

There are several factors on which the success rate of the dental implant depends. One of the most important is the quality of the patient's bone structure. For people with a fragile bone structure, an additional procedure is needed - closed or open sinus lift, depending on the amount of bone lost.

It is the dental surgeon who makes this decision following a request for a CT scan and other investigations. Based on these, he will then be able to design a personalised treatment plan for each patient.

Open or external sinus lift is a surgical procedure used for large bone resorptions to lift the patient's sinuses. The aim is to create a space or window between the jawbone and the maxillary sinuses, where the bone addition the patient needs to support the implant will be placed. To create this space, the dental surgeon must move the sinus membrane higher up.

The open sinus lift procedure is slightly more complex and laborious compared to the closed sinus lift due to the large amount of bone that needs to be replaced (the alveolar bone is less than 5mm). For this reason, the recovery period is also somewhat longer - between 4 and 8 months. Only after this period can the dental implant be inserted without problems.

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