The maxillary sinuses are behind your cheeks and on top of the upper teeth. These sinuses are empty, air-filled spaces. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.
A sinus lift procedure is also called sinus elevation, sinus augmentation, and sinus graft. The back area of the upper jaw frequently has a small amount of bone. This is due to the sinus cavity coming close to the area of the teeth. Creating an adequate amount of quality bone is the goal of a sinus lift procedure. The procedure involves raising the floor of one of the maxillary sinuses and filling in the space that is left behind with bone graft material. As the area heals for about 6 months, your body will make the real bone that is wanted to lead to implant success. Much of the bone graft material is replaced with your own bone. Bones heal slowly so there is some time needed for your body to make mature, strong bone. The implant can be placed when there is enough bone to hold the implant tight. The process of the implant fusing or integrating with the bone is called osseointegration. After this has occurred, teeth are put onto the implant.
A sinus augmentation is performed to allow a large amount of bone to be in contact with an implant. The bone is in contact with the implant, the stronger the implant and crown. There are many reasons why bone is lost in this area periodontal (gum) disease, cancer, birth defects, or resorption of calcium following the loss of a tooth. A sinus lift is performed to correct a problem with the sinuses being too close to the jaw or the height of the jawbone being too short. Often, a sinus elevation is performed in preparation for the placement of a dental implant to replace a tooth that has been lost. The implant needs dense, strong bone for there to be long-term success.
The process usually begins with imaging to evaluate the structures in the skull and the health of the jawbone. This may involve X-rays or a computed tomography scan. There are several different possible techniques by which a sinus elevation can be performed. Dr. Wiland will discuss these with you and make a recommendation based on your condition. The lateral window technique involves making a small opening into the bone from the side. The lining of the sinus (Schneiderian membrane) is lifted or moved into the sinus cavity. Bone is placed to hold the membrane in place.
Another technique is called a vertical approach. This involves moving the sinus membrane vertically through an extraction site or from an opening on the ridge and not from the side. The membrane is elevated and bone is placed to hold the membrane in its new position. In either case, space is created under the membrane of the sinus and held in place with bone graft material. A small incision is made and the gum is gently moved to give access to the bone. After the procedure is completed, sutures are placed to allow the area to heal quickly. You are completely numb during the procedure. Frequently, sedation is also used.
If you are having the sinus augmentation performed to support a dental implant, it may be possible to place the implant at the same time as the grafting. However, usually the area will heal for about 6 months before an implant is placed.
The maxillary sinus is a natural hollow structure within the bone of the upper face. The actual function of the maxillary sinus is unknown. The maxillary sinus is relatively small in size in the newborn and continues to expand until a person reaches 25 years of age. In many cases the maxillary sinus will expand around the roots of the upper premolars and molars. When the upper premolars and molars are lost, sometimes there is not enough bone height below the sinus to place a dental implant. A sinus graft or sinus lift procedure is performed to “lift” or move the sinus membrane higher. This allows for your own bone to grow below the membrane increasing bone height for dental implant placement.
A sinus lift is performed to restore the proper amount of bone and to allow for hard, dense bone to form. The procedure is performed in preparation for a dental implant so that the jaw becomes strong enough to support it.
Contact our office to schedule a consultation to determine whether you are a candidate to elevate the sinus floor and strengthen the back area of the top teeth.
More information is available in the procedure brochure.
Bruce B. Wiland, DDS, MSD is board certified in the specialty of periodontics which includes the placement of dental implants. Other services include laser periodontal therapy, esthetic tissue contouring and nonsurgical treatment.
Sedation is always available to relieve apprehension.
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