The maxillary sinus is a cavity in our face that has several functions, primarily dealing with breathing and the respiratory functions of the nose.
A sinus lift is an implant-related procedure(the best replacement for a missing tooth.) A good part of the population is not familiar with this particular dental procedure.
In this article, we try to explain what it is, how the procedure is performed, its benefits, and its indications and contraindications.
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WHEN WOULD I NEED A SINUS LIFT?
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Many patients who have lost their upper teeth or have been missing teeth for a long time and need dental implants, often require a procedure called maxillary sinus lifting in conjunction with their implant placement.
When we lose teeth or have missing teeth in the posterior region of the maxilla (upper jaw, at the back of the dental arch), with the passage of time, loss of a large amount of bone height can occur. The more bone that is lost, the less bone volume available under the maxillary sinus to house implants.
The sinus is surrounded and enclosed by a thin membrane. This membrane can be elevated for the placement of a bone graft. Once grafted, one must wait the necessary time for the stabilization and densification of the bone and placement of the dental implant.
WHAT IS THE MEMBRANE THAT THE SINUS IS ENCLOSED IN?
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This membrane is called the Schneiderian membrane.
It completely surrounds the sinus cavity. By lifting the membrane, we managed to create a “space” below if for the placement of a bone graft, and subsequent dental implant.
HOW IS A MAXILLARY SINUS LIFT PERFORMED?
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When there is insufficient bone height in the upper jaw, and implants are required, a lift of the maxillary sinus becomes a requirement in order to provide adequate and suitable bone height and volume to house the implants. Bone graft material is used in the sinus lift process, which is performed by either mechanical or hydraulic means. The space that is created after the lift is back-filled with bone graft material so that dental implants can subsequently be placed. Once healed, the implants become stable and rock solid in the new mass of bone. At that point, a crown or a removable prosthetic (denture) can be placed on the implant(s) to complete the restoration process.
The entire process involving the manipulation of the sinus is a completely safe procedure and very routine. The technique is a highly successful one, with a long and proven track record. It can easily be performed by a trained dentist right there in the dental chair, with just some local anaesthetic. The elevated region (maxillary graft) can be a small area or a larger span, depending on the number of implants required in the treatment. Multiple implants can be placed in the area that is elevated, when the ultimate plan is for an implant denture.
WHEN ARE IMPLANTS PLACED IN THE GRAFTED BONE, AFTER A SINUS LIFT HAS BEEN PERFORMED?
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There are two scenarios in which a dental implant can be placed after a sinus lift:
The first is when there is a large enough amount of bone present in the surgical site, in which case the maxillary sinus lift surgery is a minor one. In such cases, the implant can be placed at the same appointment as the sinus lift. Once both parts are complete, there is an average of six months of waiting before the missing tooth is restored on the implant that has been placed.
The second is when there is very little bone height and volume remaining in the surgical site. In this case, only the surgery to lift the maxillary sinus is performed. Placing the implant has to wait until the bone graft in the sinus lift region has densified and stabilized. In such a scenario, one must wait at least six months before placing implants in the grafted area and another four to six months before restoring the missing tooth on the implant.
WHAT TYPES OF GRAFT ARE THERE?
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There is autogenous graft material, which is derived from the dental patient themselves from a donor site typically in the oral cavity, allograft (human bone from a tissue bank), xenograft (animal source: bovine or porcine most commonly) and synthetic graft. A mixture of any of the above grafts can also be used. All have excellent and very predictable results in sinus lift procedures as well as in routine bone grafting procedures.
WHAT ARE THE INDICATIONS FOR LIFTING THE MAXILLARY SINUS?
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After having lost a tooth or several teeth, the main indication for a sinus lift is if there is very little bone present in the posterior region of the upper jaw (maxilla), and the goal is to install a dental implant.
WHAT ARE THE CONTRAINDICATIONS?
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Contraindications for sinus lifts include the patient having chronic sinusitis, uncontrolled diabetes, neoplasia, presence of an active sinus infection, among other conditions.
WHAT PROBLEMS CAN ARISE DURING A SINUS LIFT PROCEDURE?
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This procedure is relatively simple, pain-free and highly successful. The most frequent problem or complication that is encountered is the perforation of the maxillary sinus membrane, but this is easy to solve. The Schneiderian membrane is one of the fastest healing tissues in the head and neck region. In most cases, membrane perforations can be easily repaired before the implant is placed. Tears and perforations often self-heal without little to no intervention, so if the perforation is a large one, then one should wait a few months and perform the lift again.
More commonly, an infection can arise in the grafted area. This can easily be controlled by a simple round of antibiotics.
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Prevention is key!
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Marchwood Dental Clinic specializes in implants and aesthetic treatments, focusing on the oral and dental health of patients in Kanata, Carleton Place, Almonte, Carp, and all of West Ottawa. We offer many treatment options and alternatives with cutting-edge technology to guarantee the quality of our service.
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