Sinus lifting. What is it and is it always needed?

Tooth loss is an aesthetic loss and a serious threat to the health of the digestive system. Fortunately, modern dentistry is able to correct any error. The most popular method of restoring teeth is implantation, which allows you to abandon removable dentures and restore any number of lost teeth, and sinus lifting is a procedure often necessary for high-quality implantation.

What is a sinus lift?

The bone of the upper jaw refers to the air-bearing or porous bones. It forms a large cavity filled with air (maxillary sinus), which is located immediately above the roots of the upper chewing teeth.

Bone deficiency develops as a result of individual anatomical features, but even with the removal or loss of several teeth, the bone easily atrophies (in this case narrows) due to the lack of further loads. In this case, there is a need for a sinus lift, which allows you to achieve the required bone thickness for further implantation.

The sinus lifting operation increases the volume of the bone tissue of the upper jaw by lifting the mucous membrane of the bottom of the maxillary sinus. In the resulting space, the bone grows to the required volume by filling it with bone substance.

The maxillary sinus is filled with air and raising its mucosa by a couple of millimeters does not lead to serious consequences, but allows you to achieve a better result with dental implantation. The operation is done only on the lateral sections of the upper jaw.

Types of sinus lifting

Produce open and closed sinus lifting.

Closed sinus lift

Closed sinus lifting is a less traumatic method, as it provides an opportunity to move the sinus floor through the tooth opening and, in certain cases, install the implant at the same time, avoid extensive dissection with subsequent suturing, and reduce the healing period. Closed sinus lifting is indicated only in cases where the bone thickness reaches 7-8 mm. With a smaller bone thickness, an open sinus lift is used.

Balloon sinus lifting

Balloon sinus lifting is a type of closed sinus lifting. The balloon method makes it possible to place an implant at the same time by introducing a bone substitute even when the thickness of one's own bone is only 5-6 mm, at a time when a minimum of 7-8 mm of thickness is required for this.

With this method, a special catheter with a balloon is inserted into the sinuses of the nose to inject a special liquid, through which the entire manipulation is carried out.

Open sinus lifting

With an open sinus lift, a small hole is made in the side wall of the sinus, through which the mucous membrane of the maxillary sinus rises and the bone substance is filled. It takes several months for the engraftment of osteopathic material and wound healing, and even with a smaller bone thickness than 4 mm, implantation is carried out only after 4-6 months.

Is a sinus lift always needed?

Each surgical manipulation, regardless of type, volume or location, is a rather complicated procedure requiring further rehabilitation. That is why both patients and doctors tend to avoid any surgical intervention. But this is not always possible, especially when implanting chewing teeth.

The fact is that, according to the decision of leading clinics and companies (Nobel Biocare regulation), it is forbidden to install implants in the chewing parts of the jaws shorter than 10 mm and with a smaller diameter than 4.3 mm, as well as with a smaller width of the own bone than 4 mm.

The use of sinus lifting during dental implantation allows you to install implants even in the most depleted bones of the upper jaw.

Preparing for the operation

Preparation for surgery includes:

1. Initial consultation;
2. CT (computed tomography) of the upper jaw;
3. Laboratory stage.

The initial consultation reveals:

• inflammatory processes, hidden foci of infections;
• bite features, possible pathologies (by examining plaster models of both jaws);
• early surgical interventions in the sinus region;
• anatomical restrictions, bad habits that slow down the timely healing of wounds or infect.

Panoramic x-rays allow you to assess the height of the bone tissue and the features of the sinus. It is also worth immediately agreeing on the cost and preferred materials.

CT scan

The maxillary sinus is examined from the inside using computed tomography data loaded into a program that allows the use of a 3D model of the jaw for virtual sinus lifting, placement of implants and measurement of the required amount of bone material.

The laboratory stage involves the manufacture of stereolithographic models of the jaw from plastic and a surgical template based on a ready-made computer plan.

Only careful planning and compliance with the rules minimizes the risk of complications and unforeseen situations, as well as the duration of the operation itself.

Contraindications

As a medical procedure, the use of a sinus lift for dental implants also has its limitations.

1. General contraindications for sinus lifting are disorders of blood clotting and metabolic processes, poor regeneration of bone tissue, and a condition after chemotherapy.
2. Absolute contraindications are oncology, the presence of even benign tumors in the head and neck, allergies to painkillers, post-infarction condition and cardiac pathologies, as well as various mental illnesses.
3. A relative contraindication may be the presence of inflammatory diseases of the oral mucosa and caries, which postpones the operation only for a short time.

Rehabilitation

The postoperative period after sinus lifting has a number of recommendations to reduce the time of wound healing and minimize possible complications. The healing period lasts from 5 to 7 days, but it is necessary to see a doctor for several weeks. Prevention of complications is carried out within 3-4 weeks, while the patient will have to adhere to several restrictions and refrain from some habits.

During this period, the following are contraindicated:

• sudden movements, any sport,
• air travel,
• blowing your nose, sneezing, coughing,
• dry, cold and hot food.

All these actions can lead to displacement of bone material, displacement of implants, infection of the sinus.

Complications

Sinus lifting during dental implantation can cause some complications during surgery or during the rehabilitation period.

The operation is fraught with a rupture of the wall of the maxillary sinus, which is corrected by patching or suturing. Most often, patching is used.

In the postoperative period, the development of inflammatory processes and bleeding, the mobility of the installed implants, the formation of an oroantral fistula, and a violation of the outflow of fluid from the maxillary or nasal sinus are possible.

In the treatment of complications, the issue of taking certain medications can only be decided by a doctor. Sometimes antibiotics are prescribed, in other cases, sanitation and irrigation of the focus are necessary (with the formation of a fistula). If the sinuses of the nose hurt, you need to contact your dentist or an ENT doctor, since the pain can be a consequence of not only a simple runny nose, but also beginning sinusitis.

Sinus lifting in dentistry is presented by some doctors as a not so complicated and simple procedure. However, before any medical intervention (except for urgent and extreme cases), you need to thoroughly consider the pros and cons. First of all, you need to carefully choose the clinic and the doctor you want to see. Choose a doctor with the most experience, and a clinic specialized specifically in sinus lifting.