What is sinus lifting and when do we need this intervention?

 Sinus lifting or sinus lift is a surgery specific to dental implantology, through which the sinus membrane is lifted to allow bone addition and implant insertion.

The maxillary sinuses are large, hollow cavities, filled with air, which are in the thickness of the maxillary bone. The doctor can locate these formations with the help of orthopantomography (panoramic radiography) and can inspect them with the help of dental tomography (3D radiography). The maxillary bone, in the posterior area, naturally has a rather low density. If the maxillary molars were removed a long time ago, the sinus will enlarge and the bone beneath it will resorb. Because of this, there will not be enough bone between the outer edge of the bone crest and the lower limit of the sinus - at least 10mm - making it impossible to insert implants. We recommend replacing extracted teeth with dental implants as soon as possible after extraction, to prevent the need for this intervention and reduce the costs of oral rehabilitation.

Sinus enlargement can also be caused by periodontal disease, atypical jaw anatomy, trauma, chronic infections, osteoporosis or aging.

Sinus lifting techniques:

In order to restore the volume of the maxillary bone, we have 2 variants of sinus lift: internal and external. The choice of procedure will be established by the surgeon who will examine you and plan the operation. When bone loss is minor, internal sinus lift intervention is used, but when bone loss affects a large area, external sinus lift is used.

External sinus lifting is a complex operation and is performed on the side of the upper jaw, from the cheek. After cutting a small cavity, the doctor lifts the sinus membrane (a very thin membrane) with special tools and inserts the bone graft over which he applies a collagen membrane or PRF autologous membrane.  

The advantage of this technique is that the surgeon has very good visibility of the sinus membrane and the risk of accidental perforation of it is minimal. In the case of this operation, the implant can be inserted after 4-8 months, depending on each patient.

Internal sinus facelift is applied when only 1-2 mm bone addition is needed and the implant can be inserted in the same session. This intervention is done with the so-called "blind technique", because it is performed with the help of measurements on dental tomography. It takes experience and skill on the part of the doctor, because the risk of accidentally breaking the sinus membrane is higher. However, with the latest technology used by our doctors, this risk is almost zero. The device with magneto-dynamic technology and the piezo-surgery one allows penetration into the bone without affecting the adjacent structures and keeping the soft tissues intact. The biggest advantage of this technique is the short healing time, so the patient will enjoy the new prosthetic restoration much faster.

Several types of bone grafts can be used for bone addition. The surgeon will choose the most suitable option for you, depending on the results of the tests and the anatomical features.

• Autologous bone graft  refers to the addition of a quantity of bone taken from the patient on whom this procedure is being performed on.
• Xenograph  it is of animal origin and comes in the form of granules of different sizes. The molecular structure of this bone is the same as in humans, being possible to integrate it into the human body. Over time, the patient's body will replace the graft with its own bone tissue by osseointegration.
• Artificial bone graft is an inorganic matrix of mineral salts specific to the bone, being impossible to contaminate or rejected by the body. It is a base that the body uses to create new bone in an area where it was missing, colonizing it with its own cells at a rate of about 1 mm per month.

In general, the purpose of bone addition procedures is to correct abnormalities and aesthetic defects of the jaw bones, to create a solid foundation for dental implants and work on them, by increasing bone volume. In addition to sinus lifting, we use bone addition in the treatment and preservation of the postextractional alveolus and horizontal and vertical bone augmentations.

What is the success rate of bone addition?

These types of interventions are prepared by the doctor using digital technology and three-dimensional planning. Thus we manage to perform a precise intervention, avoiding unpredictable complications. The "gold standard" for investigation, diagnosis and treatment planning is digital dental tomography, or CBCT, which you can learn more about. this post

Bone addition is a safe and predictable treatment with a very low complication rate, if the following conditions are met:

• The surgeon has the necessary experience and specializes in such operations
• Quality biomaterials and advanced equipment are used
• The patient strictly follows all the doctor's instructions (oral hygiene, smoking, diet, rest medication, controls, etc.).

Horizontal bone additions - bone thickening - are more predictable and have a higher chance of success than vertical bone additions - bone augmentation.

Recommendations after bone augmentation surgery:

Your surgeon may prescribe antibiotics and painkillers, which you should start immediately after surgery. Strict adherence to the recommendations reduces post-surgical pain, promotes healing and reduces the risk of complications. 

→ In case of allergic reactions or if unusual symptoms occur, tell your doctor immediately.

→ do not blow your nose for 1-2 weeks, better use nose drops for decongestion  

→ quit smoking for at least 3-5 days after surgery

→ Avoid physical exertion and demanding sports for a period of 4-6 weeks, otherwise you risk creating microcracks in the graft, preventing osseointegration.

→ Avoid drinks that are too hot, too cold, carbonated and spicy, hard or crunchy foods

→ not sneezing with your mouth closed, but with your mouth open

→ brush your teeth with a soft toothbrush and avoid the operated area

→ try not to sleep for a few days on the operated side

→ You should avoid flying, parachuting and diving because it creates changes in sinus pressure, which can lead to bleeding or other complications.

Before the surgery, talk openly with your doctor about your concerns and don't forget the 7 questions in this post