Sinus Lift Procedure
A
sinus lift is a bone grafting procedure that is sometimes performed as a
part of preparing a site for a dental implant. A sinus lift is required
in those instances where the amount of bone found in a patient's upper
jaw (in the region originally occupied by their bicuspid or molar teeth)
is inadequate to accommodate the planned implant.
Situations that might necessitate that a sinus lift
be performed before a tooth implant can be placed.
There can
be several reasons why the amount of bone found in the patient's upper
jawbone might be insufficient to accommodate a dental implant. Some of
them include:
-
The patient's normal jaw anatomy presents complications.
The relative size and shape of an individual's upper jaw as
well as the current size and shape of their maxillary sinus (the
size of the sinus can change with age) varies among people. While
over simplified, any one person may have a combination of a
relatively small upper jaw and relatively large sinus which together
create a situation where there is an insufficient amount of bone for
the placement of a tooth implant.
-
The patient has experienced bone loss due to gum disease.
In situations where advance periodontal disease (gum disease)
is present, the bone that surrounds and supports the person's teeth
is damaged. In the most severe cases, significant amounts of bone
can be lost from around the person's teeth, to the point where there
is no longer an adequate amount of bone in which to place a tooth
implant.
-
Bone resorption associated with previous tooth extractions.
When teeth are extracted the bone that originally held the
teeth in place will undergo a process called resorption. The net
effect of this process is that much of the bone in the region
originally occupied by the tooth is lost, possibly to the point
where there is an insufficient amount of bone in which to place a
dental implant.
The magnitude of post tooth extraction bone loss can be as much as
40 to 60 percent within the first three years after teeth have been
removed. Beyond that point, the rate of bone loss typically subsides
substantially. The cause of post extraction bone resorption is
typically attributed to disuse atrophy, decreased blood supply,
localized inflammation and/or unfavorable pressure from a dental
appliance (denture or partial denture).
-
Bone loss due to other factors.
In some cases a bone deficiency may be associated with a
previous surgical procedure such as a difficult tooth extraction or
the removal of a cyst or tumor.
How is the sinus lift procedure performed?
The sinus
lift is a surgical procedure. The specific technique that the oral
surgeon
utilizes can vary depending upon their training and experiences but
traditionally the procedure has been performed as follows:
-
The oral surgeon will make an incision in the patient's gum tissue on the
cheek side of their upper jaw in the area where the placement of the
dental implant is planned (in the region originally occupied by the
patient's bicuspid or molar teeth). This incision allows the
oral surgeon
to flap back the patient's gum tissue and expose the jawbone that
lies underneath.
-
The exposed bone is cut in a fashion where a "trap door" of bone,
hinged at the top, is created. This movable section of bone is then
pushed gently inward and upward into the sinus cavity. This bone
movement caries the sinus membrane attached to it with it, thus
"lifting" the membrane (and hence the sinus floor) to a new, higher
level. The empty space underneath the lifted sinus membrane is then
packed with bone-graft material thus providing the new bone into
which the tooth implant will be placed.
-
Once the bone-graft material has been positioned the gum tissue is
stitched closed.
In some
instances it can be possible that the
oral surgeon will place the dental
implant at the same time that the sinus lift is performed. In most
cases, however, an oral
surgeon will allow a healing period of six to nine
months before the dental implant is placed. The specific time frame
allowed for healing is dependent upon the type of bone-graft material
that has been utilized.
What types of bone-graft materials are used with
the sinus lift procedure?
Several
different types of bone-graft materials can be utilized with the sinus
lift procedure. In some instances the patient's own bone will be used,
such as bone harvested from another location in the patient's mouth or
else from other bones (including the hip (iliac crest) or shin bone
(tibia)). In other instances prepared bone (frozen bone, freeze-dried
bone, demineralized freeze-dried bone), either human or from another
species (i.e. bovine), can be purchased from a tissue bank for use.
Another alternative involves the use of synthetically derived graft
material such as hydroxyapatite.