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Implant placement in the upper jaw may be challenging due to the bone quality, as the maxilla is composed of spongy or porous bone, limited bone quantity, and proximity to the maxillary nasal sinus.

Any resorption of the bone caused by periodontal disease or tooth loss will result in insufficient bone for a successful implant placement.

Sinus lift surgery is a solution for inadequate bone in the premolar-molar area of the upper jaw before implant placement.

What is a Sinus Lift?

The anatomical view of the skull reveals the presence of paranasal sinuses, which are air spaces in the skull that serve to lighten its weight and humidify the inhaled air. The maxillary sinus is the largest paranasal sinus, pyramidal in shape, and located in the maxilla.

A sinus lift surgery, in other words, sinus augmentation surgery, is a procedure in which the floor of the maxillary sinus membrane is elevated to create a space for bone graft insertion. This stimulates bone formation to improve the quality and quantity of bone at the future implant site.

Contraindications of Sinus Lift

A sinus lift is indicated when there is bone resorption in the upper jaw, making it difficult to insert dental implants. The following cases contraindicate a sinus lift surgery:

  • Active sinus infection.
  • Chronic and recurrent inflammation of the nasal sinuses.
  • Tumor in the maxillary sinus.
  • Previous radiotherapy to the maxilla.
  • Medical contraindications such as uncontrolled diabetes and bleeding tendency.
  • Alcoholics and heavy smokers.

Sinus lift procedure at Camden High Street Dental Practice

When you seek implant placement to restore a missing tooth, our experts in Camden will examine the intraoral conditions, digital X-rays, and cone beam CT scans to develop your most suitable treatment plan.

When the missing tooth is in the premolar-molar area (where the maxillary sinus lies above its roots), and a low bone amount or density is evident, you will be referred to our periodontics division for a sinus lift.

During surgery, local anesthesia will be administered, followed by a small incision in the gums to expose the bone. A small window is created in the bone to access the sinus floor. The removed bone is pushed to lift the sinus floor like a trap door, and the space created will be filled with bone grafts to stimulate bone formation. Finally, the incision is closed.

The bone graft material can be either autograft, bone taken from the patient himself, or allograft, artificial bone material.
The healing and new bone formation period takes around 4-12 months, depending on the amount of bone required.
After healing, you can schedule your implant placement surgery. Sometimes, the surgeon may place the implant during sinus lift if there is a minimum of 3mm of bone all around.

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Recovery after Sinus Lift Surgery

After sinus lift surgery, you may experience minor pain, swelling, or discomfort. You may also experience slight bleeding from your mouth or nose. These symptoms will resolve within a few days.
Your surgeon may prescribe antibiotics to prevent infection, painkillers to reduce pain and discomfort, nasal saline to keep your nose moist, and antimicrobial mouthwash.
After surgery, avoid sneezing and blowing your nose to prevent graft material displacement or losing stitches.
During the first night after surgery, elevate your head with two or more pillows while sleeping.
Avoid chewing on the surgical site and stick to soft foods in the first few days.
A check-up visit one week after surgery is scheduled to remove any unresolved stitches and monitor the healing process. Additional follow-up visits will be necessary to monitor the bone formation process or to monitor the osseointegration around the implant if placed at the same time as the surgery.

Complications and risks of Sinus Lift surgery

Perforation of the maxillary sinus: although rare, rupture of the maxillary sinus is the most common complication that may occur. In this case, the surgeon will stitch it or place a patch over it.
Surgical complications: as with any other surgery, some complications may occur, such as bruising, swelling, pain, and bleeding from the surgical site or nose. These complications are rare with sinus lift surgery. Follow your post-operative instructions. They commonly resolve within a few days.
Acute maxillary sinusitis:  may be because of the inflammation of the maxillary sinus membrane and failure to drain the mucous through your nose.
Graft dislodgment may occur if you flow or sneeze after surgery before graft healing.
Contact your surgeon immediately if you experience pain worsening over time, bleeding continuing after two days, or fever.

Sinus lift alternatives

If you choose not to have a sinus lift surgery, missing upper tooth or teeth can be restored through:

  • Dental bridges: if there are neighboring natural teeth to the missing area, fixed bridges can be constructed.
  • Dentures: when all or most teeth are missing, a removable denture is used to restore missing teeth and surrounding structures, such as resorbed bone and soft tissue defects.
  • Zygomatic implants: these are implants inserted in the cheekbone to support implants when there is no sufficient bone or a failed sinus lift procedure.

Frequently Asked Questions

A procedure involves elevating the floor of the air sinus in your maxilla to create space for new bone formation and implant placement.

Patients seeking implant replacement for a missing upper tooth when they do not have sufficient bone quality or quantity at the intended implant site.

The procedure is performed under local anesthesia and sedation, so you will not feel any pain during the surgery. After surgery, you may experience mild pain for a few days. Your surgeon will prescribe painkillers to minimize discomfort.

Bone regeneration at the surgical site of the sinus lift may take around 4 to 12 months, depending on the amount of bone needed. In some cases, implants can be placed during the same surgery as a sinus lift when there is a minimal amount of bone (3mm) all around for initial implant stabilization.
Our dental implant team is one of the UK’s foremost lead by Dr Javier Perez. We are pioneers in our procedures, having completed over 5000 implants with a combined 50 years experience. Patients come from all over the United Kingdom to be treated by our implant team

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Dr Javier Perez

GDC No. 225487

Dental Implant and Oral Surgeon Expert

Dr Javier Perez graduated in dental surgery in 2010.

His clinical practice is focused on dental implants and oral surgery, from simple single tooth replacements to complex reconstructions involving both soft and hard tissues.

Dr Javier has completed a Masters in Implant Dentistry MClinDent (Implant) in London over three years and was awarded a diploma in Oral Surgery from the Royal College of Surgeons of England, one of the most prestigious colleges in UK.
Dr Perez has trained in Oral Surgery at the Maxillofacial Unit in the Queen Victoria Hospital NHS Foundation Trust in South England. He is at the forefront of dental implants and oral surgery regularly attending National and International conferences to develop his skills and learn about the latest trends in Implantology.

At Dulwich Dental our implant team have placed over 5000 implants, often undertaking and being referred cases from other practioners. We also consult and treat cases where you may have been told that you are unsuitable for dental implants. Having assembled one of the countries leading dental implant teams we can treat the most advanced and complex cases here at Dulwich Dental Office.

Outside of work Dr Javier spends the majority of his time with his young family, recently welcoming a new son (October, 2021). He enjoys spending weekends exploring London, especially going to local food markets.

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