This surgical procedure adds bone to your upper jaw in the area of your back teeth (only if required).
This procedure is only necessary if implants are to be placed in the area of your upper molars and premolars, and the CT scan reveals that more bone is needed to secure the implants. A report from your CT scan will be written by Dr Brookshaw, and you will be notified accordingly.
The maxillary sinuses are natural air spaces that exist behind your cheeks and above the upper back teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the upper teeth extend up into the maxillary sinuses.
When upper teeth are removed there is often just a thin wall of bone separating the maxillary sinus and the mouth, insufficient to use for dental implants. Dental implants need bone to hold them in place. To overcome this difficulty there is a possible solution called a sinus graft or sinus lift.
A sinus graft procedure involves lifting the lining membrane of the sinus creating a space into which donor bone or bone substitute can be placed. The sinus graft makes it possible for our patients to have dental implants- years ago there was no other option than wearing dentures.
From a patient perspective, this usually just adds a short time to your appointment. The implant is often placed at the same time whilst you are numb from your anaesthetic, and there will be no discomfort felt.
There can be a number of reasons why there may not be enough jaw bone. In some cases, it can simply be due to the natural shape of the skull – especially if you’ve lost teeth at the back of your mouth. Alternatively, gum disease can cause the bone to be eroded as well as the gums. Also, if you have been missing teeth for a long time before deciding to get them replaced, your body may naturally have begun to reabsorb the bone as it thinks it is no longer required.
Finally, as the name for the treatment suggests, the position of the sinus can have implications. If the sinus is very close to the bone where the implants need to be secured, this can also mean that extra bone needs to be grafted into place before the implant can be attached.
In modern dentistry, the surgical procedure is common and straightforward. The most important element of the preparation from your dentist’s perspective is to ensure that your jawbone and sinus position are measured very accurately. This usually requires a CT scan. In most procedures, the surgeon will need to increase the thickness of the jawbone by several millimetres. Therefore, the surgeon will cut and raise the gum to expose the bone and then also cut into the bone so that the sinus membrane behind it is revealed. Once this has been done, the surgeon then grafts the new bone material into the space between the membrane and the jawbone.
Once the procedure has been completed and your gum has been stitched up again, it will take around nine months for the graft to ‘take’ and to become strong enough to allow implants. After all, the dental sinus lift is really only the first phase of your treatment. Once the sinus lift has been deemed successful by your dentist, you can progress to having your implants made and your teeth finally replaced. The implants themselves usually take around three months, and a couple of visits to your dentist, to fit. Some people can be ready to receive their implants in as little as six months. Every case is individual. Some dentists also use proteins to try to accelerate the healing time.
The essential difference between a sinus lift and a sinus graft is that the sinus lift is a one-stage surgical process, with the implants being placed at the same time. As long as the implants can be placed in a stable position this is usually the preferred treatment approach. Every case is different however, and the surgeon has to respond to conditions found on the day of surgery. If there is insufficient bone to place the implants, the graft procedure would normally be completed first. In this situation, a period of healing to allow the bone graft to settle is needed, and further assessments and scans may be necessary before moving on to implant placement.
Grafting materials vary in their make up and may be synthetic or produced by the special treatment of bovine bone. These products can be enhanced with bone taken from around the surgery site, or from a remote location within the mouth. These materials form a scaffold for the production of your natural new bone.
The availability of bovine derived bone substitutes has made it possible to avoid traumatic and expensive secondary surgery to obtain bone once thought essential for effective bone replacement. The product we use ‘Bio-Oss®’ is deproteinized (purified) bovine bone, frequently used in dental practices to promote bone regeneration. It is biocompatible and osteoconductive (permits bone growth) and slowly resorbed in humans, and it is one of the best-documented biomaterials used in sinus surgery.
A sinus lift or graft procedure is an invasive procedure and by its nature involves the disturbance of hard and soft tissues around the operation site. This results in a number of common problems such as swelling, bruising and discomfort, which are be considered normal for a procedure of this kind. You will be provided with any necessary prescription or over the counter medicines to manage these symptoms. Usually these common problems pass within a few days of the surgery, but it may take up to 3 weeks, or in rarer cases longer, for things to return to normal. We would normally advise you to allow for 10 days of rest and recuperation.
Further problems may occur but will only become apparent as time moves on and in the interest of providing full information these are detailed below. It must be stressed that however undesirable these complications might sound they are not common and can usually be managed with either medicines or further corrective surgery. In most cases where these complications arise it simply means that the desired, end result is delayed.
These complications are fortunately rare, but can include (but not be restricted to) the following.
If you have any questions about this procedure, the information provided here or what the implications may be for you please contact us, or ask your dentist.