Anatomical Considerations of the Sinus
The topic of sinus lifts may sound difficult to get excited about. However, it is an important surgical procedure for many considering future implant treatment for upper molars. The teeth and sinuses are often more closely linked than many realize. The sinus cavities often closely surround the roots of your upper molars, separated by a thin layer of bone. Because this layer of bone is usually too thin to support the structure of an implant, oral surgeons often need to fortify the area with additional bone and create more vertical height in order to properly seat an implant.
When the sinus cavity is particularly close to the roots of the tooth area that is being restored, the risk of communication or perforation of the sinus grows higher without taking the necessary step of having a sinus lift completed prior to implant treatment. There can be a risk of this happening with the tooth extraction as well.
If the sinus becomes perforated during a procedure, this could lead to sinus infections for the patient if not addressed. The patient may feel air in the tooth socket when they speak and may have blood, water or bone particles pass into their sinuses.
To close a communication with the sinus, a surgeon uses a variety of surgical techniques and a collagen membrane to cover the hole. The patient should then follow strict guidelines to ensure proper healing. He or she may be cautioned against blowing their nose forcefully, spitting or creating other significant pressure changes in their mouth. For example, they may be asked to sneeze with their mouth open instead of closed to avoid the pressure it might create within the mouth.
Types of Sinus Lifts
Sinus lifts are often completed after a tooth extraction site has had some time to heal. They may be performed at the time of your implant surgery or prior to an implant placement based on the amount of bone available at that time.
There are two main types of sinus lifts: vertical and lateral. In both, the object is to achieve sufficient vertical height and bone structure for a future implant; however, they differ in the surgical approach by which this is accomplished.
A vertical sinus lift involves adding bone to the upper jaw directly above the back teeth and under the sinus at the previous extraction site. Compared to the lateral sinus lift, the vertical sinus lift is more cost-effective and requires only a few millimeters of bone height.
In contrast, a lateral sinus lift entails accessing the sinus cavity from the side of the jaw. A small window is created in the jawbone, and the sinus membrane is gently pushed upward to make space for the bone graft. During the procedure, the sinus membrane is teased off the bony wall, and bone is placed underneath it, slightly changing the shape of the sinus but not affecting its function.
What does recovery look like?
The entire healing process of an extraction, sinus lift and dental implant can take up to 10 to 12 months, with the sinus graft alone often requiring five to six months of healing time.
It’s normal to experience some swelling and minimal discomfort for up to two or three days after a sinus lift. The oral surgeon will likely prescribe pain medication and antibiotics to help manage pain and prevent infection. Patients are also advised to follow sinus precaution guidelines during the first few weeks following the procedure. Again, the object is to avoid pressure changes within the mouth, which may also include drinking through a straw or traveling in an airplane.
It’s also relevant to note that not everyone is a good candidate for a sinus lift. Patients who often smoke, have had any previous sinus surgery, or suffer from acute or chronic sinus problems may not be in a position to undergo a procedure like this. It’s best to consult your oral surgeon to determine if a sinus lift is right for you.
Though a sinus lift may sound intimidating, it’s a routine procedure that can help ensure the success of your dental implant. Talk with your dentist and schedule an appointment with your local oral surgeon to further discuss your restorative options.
Dr. Brian R. Cherry of Cherry Orchard Oral and Implant Surgery proudly serves Greenville, SC and the surrounding areas of the Upstate. Dr. Cherry has had extensive training in oral and maxillofacial surgery and has honed his skills in performing sinus lifts over the many years he has been in practice. Give our office a call today! (864-603-2464)