A lateral sinus lift, also known as a sinus augmentation or sinus graft, is a surgical procedure that adds bone to the upper jaw in the area of the molars and premolars. This procedure addresses situations where there is insufficient bone height in the posterior upper jaw, often making it difficult or impossible to place dental implants. The goal is to create a stable foundation for dental implant placement by increasing bone between the jawbone and the maxillary sinuses. This involves carefully lifting the sinus membrane to create space, which is then filled with bone grafting material.
Reasons for a Lateral Sinus Lift
One primary reason for undergoing a lateral sinus lift is insufficient bone height in the posterior upper jaw, which often occurs after tooth loss. When teeth are lost, the jawbone in that area can resorb or shrink over time, leading to a decrease in bone density and volume. This bone loss can be exacerbated by long-term tooth absence, periodontal disease, trauma, or even untreated tooth decay that spreads to the bone.
The natural anatomy of the maxillary sinus also plays a role, as these air-filled cavities are located above the upper back teeth. In some individuals, the sinus floor may be too close to the existing jawbone, leaving inadequate space for dental implants. As people age, the sinus can also naturally enlarge, further reducing the available bone volume. A lateral sinus lift directly addresses these issues by creating the necessary bone volume to securely anchor dental implants.
The Surgical Process
The process for a lateral sinus lift begins with an assessment and planning phase, which typically includes advanced imaging like computed tomography (CT) scans. These scans allow the dental surgeon to precisely measure the existing bone height and width, and to evaluate the overall health and anatomy of the maxillary sinus. This detailed imaging helps determine the most suitable surgical approach and ensures accurate planning for the bone graft.
Anesthesia options are discussed to ensure patient comfort throughout the procedure, often including local anesthesia, sometimes combined with sedation. During the surgery, an incision is made in the gum tissue near the upper molars or premolars, and the gum tissue is gently elevated to expose the lateral bony wall of the maxillary sinus. A small, precise access window is then carefully created in this bone using specialized instruments like a high-speed bur or piezoelectric device.
Through this window, the Schneiderian membrane, which lines the sinus cavity, is carefully lifted away from the bone. This creates a space beneath the membrane, which is then filled with bone grafting material. The type of bone graft material can vary, including:
Autogenous bone (from the patient’s own body)
Allogeneic bone (from a donor)
Xenogeneic bone (from an animal source, such as bovine)
Alloplastic materials (synthetic)
After the bone graft material is placed, the surgical site is closed with sutures, and a membrane may be used to cover the window if needed.
Healing and Post-Operative Care
Following a lateral sinus lift, patients can expect post-operative effects, including swelling, minor bleeding, and discomfort, which peak around the third day. Applying ice packs to the face for the first 48 hours, in 15-minute intervals, can help manage swelling and discomfort. Patients are advised to keep their head elevated, even while sleeping, for about seven days to further reduce swelling.
Managing sinus pressure is an aspect of post-operative care, and patients are instructed to avoid blowing their nose for at least four weeks, and to sneeze with their mouth open to prevent dislodging the graft material. Activities that increase nasal or oral pressure, such as using straws, playing wind instruments, or lifting heavy objects, should also be avoided for a period of time. A soft diet is recommended for at least two weeks, avoiding hot, spicy, or crunchy foods, and oral hygiene should be maintained with gentle rinsing and a soft-bristled toothbrush.
The healing timeline involves a waiting period before dental implant placement, allowing the bone graft material to integrate with the existing jawbone. This bone integration phase can take approximately two to three months, but full healing often requires six months or longer. Follow-up appointments are scheduled to monitor the healing progress and ensure the success of the bone graft before proceeding with implant placement.
Factors Influencing Success
Several elements contribute to the outcome of a lateral sinus lift. The patient’s overall health and the existing quality of their bone play a role in how well the graft integrates and heals. For instance, if the bone height is between 1 and 4 millimeters, a two-phase surgical procedure, where the sinus augmentation is performed first and implant placement is done in a later surgery, is recommended.
The skill and experience of the dental surgeon performing the procedure impact the success rate. Meticulous execution, including proper incision design, careful membrane elevation, and precise placement of the graft material, are all important. Adherence to post-operative care instructions by the patient, such as avoiding activities that create sinus pressure and maintaining proper oral hygiene, also contributes to a healing environment. The quality and type of bone grafting material used can influence the outcome, though studies suggest that various graft materials can yield similar implant success rates.