Augmenting Sinus or Sinus Lift
What Is It?
A sinus lift is a surgical process that is performed to add bones to the upper jaw in the area of molars and premolars. It is also referred to as sinus augmentation.
The additional bone is attached in between your jaw and the maxillary sinuses, the largest of the paranasal sinuses located on either side of your nose.
To create space for the bone, the sinus membrane is required to be “lifted” or move upward. A sinus lift surgery is generally performed by a specialist dentist. The specialist could either be a periodontist, oral care dentist or a maxillofacial surgeon.
The posterior maxilla (the upper back jaw) can be a typically troublesome area to place an implant because of the quantity and quality of the bone as well as the closeness of the maxillary sinus which can restrict the number of bones available for the placement of dental implant.
If the reason of bone loss id due to periodontal disease or tooth loss; this may make the situation even more difficult to handle.
Sinus augmentation surgery can help rectify this issue by lifting up the sinus floor and raising the quantity of bone to permit for implant placement.
There are some strategic techniques available all with the objective of augmenting the height of the bone available for placing the dental implant.
The healing period post the sinus augmentation can vary from 4 to 6 months. Sometimes dental implants can be concurrently placed at the time of sinus augmentation which can crucially minimize the treatment time. There are several elements that will ascertain which technique is convenient to the patient.
Importance of Sinus lift or Sinus augmentation
Sinus lift surgery is chiefly carried out in the condition when there is not adequate bone height in the upper jaw area, or the sinuses are have come too near to the jaw, for dental implants to be positioned. There are various reasons for the same which are as follows:
- People who do not have or have lost teeth in their upper jaw —specifically molars or the back teeth— do not possess adequate bone for implants to be positioned. Because of the bodily structure of the skull, the back area of the upper jaw relatively posses lesser bone than the lower jaw.
- People who have lost bone due to periodontal (gum) disease.
- In many cases, Tooth loss may have resulted to bone loss as well. Once the teeth are gone, bone starts to re-soak (soaked up back into the body). If it has been a long time that the teeth have gone missing, there usually is not sufficient bone left to place dental implants.
- The maxillary sinus placed on either side of the nose may be too close to the upper jaw for the dental implants to be placed. The size and the shape of the maxillary sinus differ from individual to individual. This sinus also can become larger as a person age.
Sinus lift surgeries have become more popular over a period of last 15 years as more people prefer to get dental implants to replace missing teeth.
Preparation for sinus lift and sinus augmentation
The bone that is being used in a sinus augmentation surgery may be obtained from your own body (autogenous bone), from a cow bone (xenograft) or from a cadaver (allogeneic bone).
In the sinus life surgery, if your own bone is put to use, it will be obtained from the other areas of your body or mouth. In few cases, the dentist may also take bone from your tibia (the bone below the knee) or the hip.
You will require the X-rays to be taken before your sinus lift surgery so the surgeon is able to review thoroughly the anatomy of your sinus and jaw. You may also require a particular kind of computed tomography (CT) scan.
This scan will certainly enable the surgeon to precisely measure the width and height of your available bone and to assess the health of your sinus.
If you are prone to periodic allergies, you would need to plan the treatment when they are not in existence at the time.
How sinus lift is done
Your dentist will cut off the gum tissue from the area your back teeth used to be. The tissue is lifted, revealing the bone. An oval shaped, little window is opened in the bone.
The membrane paneling the sinus on the opposite side of the window isolates the sinus from your jaw. This membrane is smoothly shot up and away from the jaw.
Molecules of bone-graft substance are then wrapped into the room where the sinus was. The mass of bone used will differ, but generally some millimeters of bone is added above the jaw.
Once the bone gets in correct position, the tissue is then closed with stitches. Your dental implants will be placed 4 to 9 months later. This provides enough time for the grafted substance to mesh with your bone. The length of time is particularly based upon the amount of bone required.
After completed with the sinus lift procedure, you may counter a little swelling in the area. In some cases, people may also bleed from their nose or mouth. In such a situation, you are needed not to sneeze or blow your nose energetically. Either of these could lead the bone-graft material to shift, and weaken the stitches.
Your surgeon may provide you saline sprays to maintain the wetness of the inner lining of your nose and you may be given medicine to prevent inflammation, irritation and congestion.
You may also be prescribed an antimicrobial mouthwash, pain relieving medicine, or an antibiotic to help ward off against any infection. However, many patients experience only a bit of uneasiness after a sinus-lift procedure.
You will need to visit the dentist after 7 to 10 days. The specialist will examine the surgical site and discard stitches if they will not loosen up on their own. You might be asked to see the dentist a few more times to ensure that the area is healing accurately.
After a sinus lift procedure, you are required to be patient for some months for the bony material to solidify and synchronize with your jaw. Based on the grafting substance being used, dental implants will be placed in 4 to 9 months.
Many dental specialists have begun using proteins referred as growth factors to aid the new bone solidify quicker. Platelet-rich plasma, which comprises of the growth factors, is received from your blood before the sinus life surgery and meshed with the graft that is settled into your sinus.
Human-recombinant bone morphogenetic protein is an engineered protein which is now available. It prompts bone production even without grafting. The U.S. Food and Drug Administration (FDA) have approved this protein’s use in a sinus lift procedure.
Risks factors of sinus lift
The major risk associated with a sinus lift surgery is that the sinus membrane could be pierced or ripped. If the membrane is torn ripped off during the sinus lift procedure, the specialist will either stitch the tear in the sinus or put a patch over it to cover. If the repair fails to succeed, your specialist may put halt at the procedure and provide the time to heal.
Your surgeon can perform the sinus lift again once the membrane has healed. This often takes a several months. A healed membrane is likely to be thicker, bulkier and sturdier, which indicates that one more attempt at a sinus lift could possibly be successful. However, there are various other factors that could also influence success.
Infection undoubtedly is an unavoidable risk linked with any surgical procedure. Though, this hardly happens after a sinus lift.
On some occasions, the already available bone does not consolidate with the bony graft material, and the grafted area does not form a blood supply.
If this takes place, any dental implants placed in this area will not be successful because there is no live bone for the surgeon to add. If this occurs, you can repeat your sinus lift procedure.
When to Call a Professional dentist
After a sinus lift is done, contact your dental specialist if:
- Any pain, soreness or swelling gets bad over time. (It should possibly reduce after the first 2-3 days or so.)
- When the area does not stop bleeding after one to two days.
- Bleeding is onion and bright red in color. (Ordinary bleeding after a sinus lifts procedure leaks steadily and is darker red with likely clots.)
- If you feel the bony material may have been moved or displaced after blowing your nose or sneezing.
- Pain does not alleviate over time.
- You get a fever or feel feverish more often.