Dr. Manish Juneja
BDS, MDS, DNB, Cert Oral Implantology
Oral Implantologist
Mob. no. 00-91-7838386006
A Centre for Dental Implants
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                                                                                                                                  Direct Sinus Lift Procedure
                                                                                                 
 
What is sinus lift procedure and why it is done?
The upper jaw has air filled spaces on the both sides (right and left) which are called as “maxillary sinuses”. These air spaces (sinus) are lined by a thin membrane lining the entire sinus cavity.(see image below)
 
 
 
Normally when teeth are present there is enough bone to support the root of the teeth and the air filled spaces lie above the roots of the teeth. However, upon loss of teeth, the bone starts vanishing (resorbing) and the sinus cavity expands, with time this leads to decreased height of the bone. (See image below)
 
 

Due to decreased height of the bone, the dental implants cannot be placed without regaining the height required to support the titanium dental implant.

This process of regaining the bone height is done by lifting the sinus membrane and inserting bone grafting material to supports the new dental implant.

Not everyone who needs implant in the upper back region of the jaw requires sinus lift procedure. Sinus lift is required only in cases where the membrane and sinus have expanded and have come near to the crest of the ridge. 

As the bone starts resorbing immediately after the teeth are lost, it is advisable to get them replaced to prevent sinus lift procedure. In cases where teeth are lost due to periodontal reasons the bone height is decreased even when the teeth are present. The oral implantologist then decides whether sinus lift will be required or not.
 
 
 

1.                                        1. Tooth root with a high sinus and adequate bone

2.                                            2. Expanded sinus (low sinus) after tooth is lost

3.                                            3. No place for dental implant as there is not bone available to support the dental implant

4.                                           4. Sinus membrane can be lifted either from crestal approach (indirect sinus llift) or by lateral window approach (direct sinus lift)

5.                                           5. Sinus membrane lifted

6.                                           6. Bone graft inserted

7.                                           7. Implant placed

8.                                            8. Implant loaded with crown
 
 
               Sinus  lift procedure can be done in two ways- 

                   Direct Sinus Lift & Indirect Sinus Lift

                                   Direct Sinus lift procedure is advisable when more than 5 mm of bone height needs to be regained.
                                   Indirect sinus lift procedure is advisable when 3-4 mm of bone high has to be regained.
 
 
             
            Risks
                The main risk of a sinus lift is that the sinus membrane could be punctured or torn. If the membrane is torn during the procedure, it can be repaired by simple procedures.
            If the hole is beyond repair, we leave it to heal by itself which takes a few months. A healed membrane tends to be thicker and stronger,    which means a second attempt at a sinus lift is likely to be successful.                 
 
                   Infection is a risk of any surgical procedure, but very rare after sinus lift procedure.                    
  

                Rarely does the grafting procedure fails. In that case, the existing bone does not integrate with the bony graft material, and the grafted area does not develop a blood supply. The sinus lift procedure needs to be repeated.

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