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Sinus Lift

Sinus lift — elevation of the sinus floor in the upper posterior jaw when bone is insufficient.

A surgical procedure in which the maxillary sinus floor is elevated in the upper posterior jaw to provide adequate bone height for dental implants.

Indication

  • Insufficient bone height in the upper posterior jaw (premolar and molar region)
  • Maxillary sinus pneumatization (downward expansion of the sinus)
  • Alveolar ridge resorption following tooth extraction
  • Less than 5 mm of bone height in the area where an implant is planned
  • Insufficient distance for an implant between the sinus floor and the alveolar ridge

Preparation

  • Detailed evaluation of bone and sinus anatomy with CBCT (cone beam computed tomography)
  • Treatment of active sinusitis and nasal pathologies
  • Reducing smoking as much as possible
  • Control of systemic conditions and planning antibiotic prophylaxis if needed
  • Determining the graft type and one-stage or two-stage approach

How it's performed

  1. Local anesthesia is administered, with sedation if needed
  2. In the lateral window technique, access is gained from the lateral wall and the sinus membrane (Schneiderian membrane) is gently lifted
  3. In the crestal (osteotome) approach, the sinus floor is pushed upward in a controlled manner from the alveolar ridge
  4. Autogenous, xenogeneic, allogeneic, or synthetic bone graft is placed in the created cavity
  5. If sufficient primary stability is present, the implant may be placed in the same session
  6. The gum is sutured closed; the crestal approach is generally less invasive

Post-procedure

  • Avoiding nose blowing, mouth-open sneezing, and forceful nasal cleaning for the first 2 weeks
  • Cold application and keeping the head elevated for the first 24-48 hours
  • Using prescribed antibiotics, painkillers, and nasal decongestants
  • Suture removal after 7-14 days
  • Periodic follow-up during 4-9 months of graft maturation
  • Physician approval for pressure changes such as air travel and diving

Risks

  • Sinus membrane perforation (the most common complication)
  • Postoperative sinusitis or infection
  • Displacement of graft material into the sinus
  • Nosebleeds and prolonged swelling
  • Implant failure or insufficient graft maturation

FAQ

Is sinus lift a painful procedure?

Because the procedure is performed under local anesthesia (with sedation if needed), no pain is felt. Mild swelling and discomfort may follow for 2-3 days.

What is the difference between the lateral window and the crestal approach?

The lateral window provides broad access from the lateral wall in cases of advanced bone loss. The crestal approach is applied from the alveolar ridge in cases requiring less bone.

Can the implant be placed in the same session?

If the remaining bone height is sufficient (generally over 4-5 mm), the implant can be placed simultaneously; otherwise, a wait of 4-9 months is needed.

What is the risk of developing sinusitis?

With proper indication, sterile technique, and postoperative recommendations, the risk of sinusitis is limited; however, it is not entirely eliminated.