Sinus grafts, also known as sinus lifts or sinus augmentation, are surgical procedures performed in periodontics to augment the bone in the upper jaw, particularly in the posterior maxilla, where the bone height may be insufficient for dental implant placement due to the proximity of the maxillary sinus.
The sinus membrane is gently lifted during the procedure, and bone graft material is inserted into the resulting space between the sinus membrane and the jawbone. This bone graft promotes new bone growth, increasing the bone volume and density necessary to support dental implants. Sinus grafts are essential for patients seeking dental implants in the upper jaw, enabling them to restore oral function, aesthetics, and overall oral health.
When Is Sinus Lift Needed?
Tooth Loss
When teeth are lost due to decay, trauma, or extraction, the surrounding bone that once supported those teeth can begin to resorb (shrink) over time. This process of bone loss, known as bone resorption, can reduce bone height and density, particularly in the posterior maxilla.
Periodontal Disease
Chronic periodontitis, a bacterial infection that affects the gums and supporting structures of the teeth, can cause significant bone loss over time. As the bone supporting the teeth diminishes, it can affect the surrounding bone in the upper jaw, potentially reducing the available bone height for implant placement.
Sinus Anatomy Issues
The maxillary sinuses are air-filled spaces behind the cheeks and upper teeth. In some individuals, the sinuses' natural anatomy may encroach upon the upper jawbone, leaving insufficient space for dental implants. This anatomical variation can limit the height and thickness of available bone in the posterior maxilla.
Age-Related Changes
As individuals age, the maxillary sinuses can naturally expand and enlarge, a process known as pneumatization. This expansion can encroach upon the surrounding bone in the upper jaw, further reducing the available bone height for implant placement.
The Sinus Lift Procedure
- Before the sinus lift procedure, a thorough evaluation of the patient's oral health, including dental X-rays or CT scans, is conducted to assess the bone density and the anatomy of the sinus cavities. This evaluation helps determine the extent of bone deficiency and the patient's suitability for the procedure.
- On the day of the procedure, the patient is typically administered local anesthesia to ensure comfort during the surgery. Sometimes, sedation may also be provided to help the patient relax. Once the anesthesia has taken effect, the oral surgeon or periodontist makes an incision in the gum tissue, exposing the underlying bone in the posterior maxilla.
- After the incision is made, a small opening, known as a "window", is created in the bone to access the sinus cavity. This window provides direct access to the sinus floor, allowing for the subsequent sinus membrane elevation.
- The sinus membrane, which lines the interior of the sinus cavity, is carefully lifted or pushed upward from the sinus floor. Specialized instruments gently separate the membrane from the underlying bone, creating a space between the membrane and the jawbone.
- Once the sinus membrane has been elevated, bone graft material is placed into the space created between the sinus membrane and the jawbone. The bone graft material may consist of autogenous bone (bone harvested from the patient's own body), allograft (donor bone), xenograft (animal-derived bone), or synthetic bone substitutes. The bone graft serves as a scaffold for new bone growth and provides structural support for dental implants.
- After the bone graft material has been placed, the incision in the gum tissue is carefully closed with sutures. The surgical site is then covered with a protective membrane or tissue barrier to facilitate healing and prevent contamination of the graft material.
- Following the sinus lift procedure, the patient is given post-operative instructions, including oral hygiene and diet guidelines. Over the next several months, the bone graft material integrates with the surrounding bone through osseointegration. During this time, new bone forms around the graft material, increasing the bone volume and density in the posterior maxilla.
- Once adequate bone volume and density have been achieved, the patient may undergo the placement of dental implants in the augmented bone. The implants are carefully positioned and securely anchored into the newly formed bone, providing a stable foundation for prosthetic teeth.
Aftercare and Recovery
- Our surgeon will provide specific instructions on caring for your surgical site, which may include rinsing with a special mouthwash and avoiding certain foods.
- Refrain from blowing your nose, sneezing with your mouth closed, or any activity that puts pressure on your sinuses.
- Take all prescribed medications as directed, including antibiotics to prevent infection and pain relievers to manage discomfort.
- Attend all scheduled follow-up appointments to monitor the healing process and promptly address concerns.
- Keep the surgical area clean, but avoid brushing directly over the site until it has healed adequately.
The sinus lift procedure creates additional bone volume in the posterior maxilla, allowing for the placement of dental implants and restoring oral function and aesthetics for patients with missing teeth in this area. Visit Ali Haeri D.M.D., M.H.S. at 1297 W Main St., Suite A, El Cajon, CA 92020-4135, or call (619) 579-0505 to learn more.