Short answer: A sinus lift is a procedure in which, when there is not enough bone height for an implant in the back of the upper jaw, the membrane on the sinus floor is gently lifted and bone graft is placed beneath it. Depending on the amount of bone, it is done with a closed technique (through the implant site) or an open technique (through a window in the side). It can be performed under local anesthesia; the implant is placed in the same session or after the bone has matured.
When the molars in the back of the upper jaw are lost, it may not always be possible to place an implant directly in this area. The reason is the air space located just above the upper jawbone, the maxillary sinus. After tooth loss, the bone resorbs over time and the sinus can expand downward; as a result, the bone height available for the implant becomes insufficient. A sinus lift is a bone augmentation procedure performed in this situation to create sufficient bone volume for an implant. In this article we explain what the procedure is, the difference between the open and closed techniques, who needs it, the treatment process and what to pay attention to afterwards.
What is a sinus lift?
A sinus lift is a procedure in which the thin membrane lining the floor of the maxillary sinus (the Schneiderian membrane) is gently separated from the bone and lifted upward, and bone graft is placed in the resulting space. It is also called sinus augmentation or sinus floor elevation. The aim is to create new bone on the sinus floor without disrupting the function of the sinus, and thus achieve sufficient bone height for the implant to be placed.
The graft used may be the person's own bone, processed bone of human or animal origin, or synthetic bone materials. Over time these materials integrate with the person's own bone to form a structure that will support the implant. Which material is chosen depends on the amount of bone needed and the dentist's assessment.
Patients also frequently ask about the effect of the procedure on the sinus and breathing. During a sinus lift, only a small volume at the bottom of the sinus cavity, on the floor next to the teeth, is filled with graft; the rest of the sinus and its connection to the nose are preserved. For this reason, after a successful procedure, sinus ventilation and normal function are usually not affected. For the procedure to be planned this way, the anatomy of the sinus needs to be examined in detail beforehand with three-dimensional imaging.
What is the difference between the open and closed techniques?
The main difference between an open and a closed sinus lift is the route used to reach the sinus and how much bone needs to be gained. The choice is made according to the existing bone height.
Closed (crestal) sinus lift
In the closed technique, the sinus is reached through the site where the implant will be placed, that is, from the top surface of the jawbone. Using special instruments, the sinus floor is pushed upward in a controlled way and the membrane is lifted; if needed, a small amount of graft is placed in between. This technique is preferred when a certain amount of bone height is already present and only a few millimeters of extra bone are needed. The implant is often placed in the same session. Because it is a smaller procedure, complaints afterwards are usually more limited.
Open (lateral window) sinus lift
In the open technique, the gum is lifted to reach the side wall of the sinus, and a small window is opened in the bone. Through this window the sinus membrane is carefully lifted and a larger amount of graft is placed beneath it. If necessary, the window is covered with a membrane and the gum is sutured. This technique is used when very little bone height remains and more bone needs to be gained. If the remaining bone provides enough stability, the implant can be placed in the same session; if not, the graft is allowed to mature and the implant is placed in a later session.
Who needs a sinus lift?
A sinus lift is considered for people who are planning implants in the back of the upper jaw, that is, in the premolar and molar region, and who have insufficient bone height in this area. The main conditions that lead to insufficient bone are:
- Bone resorption due to teeth that have been missing for a long time,
- Downward expansion of the sinus after tooth loss (pneumatization),
- Bone loss due to advanced gum disease,
- A sinus that sits close to the teeth in the person's natural anatomy.
The sinus must be healthy before the procedure. If there is active sinusitis, severe sinus congestion or certain uncontrolled general health conditions, these may need to be treated first or an ear, nose and throat specialist's opinion may need to be obtained. Heavy smoking can also negatively affect healing and the success of the graft. Whether alternatives such as short implants or different prosthetic designs are suitable is also assessed at the planning stage.
How do the procedure and recovery progress?
In most cases a sinus lift is performed under local anesthesia in a dental office setting, and the process consists of planning, the procedure and recovery stages.
- Assessment: Bone height and the structure and health of the sinus are examined with three-dimensional CT imaging. This imaging is the key tool for deciding which technique is suitable.
- Procedure: After local anesthesia, the sinus membrane is lifted with the chosen technique, graft is placed and, if suitable, the implant is placed in the same session. The length of the procedure varies with the technique and the number of implants to be placed.
- The first days: Swelling, bruising and mild pain may appear on the face and under the eye. There may be slight bloody discharge from the nose. These symptoms usually subside within a few days.
- Bone maturation: Integration of the graft with the bone takes months. If the implant was not placed in the same session, it is placed at the end of this period; making the tooth on top of the implant also waits until healing is complete.
Possible complications of the procedure include tearing of the sinus membrane, infection, sinusitis and the graft not integrating as expected. Small membrane tears that occur during the procedure can often be repaired in the same session. Risks and individual circumstances should be discussed in detail at the planning stage.
What should you pay attention to after a sinus lift?
In the first weeks after the procedure, it is important to avoid actions that increase pressure inside the sinus so that the graft stays in place and healing progresses smoothly. Your dentist's instructions take priority; general recommendations are:
- Do not blow your nose: Avoid blowing your nose forcefully in the first weeks; if needed, wipe your nose gently.
- Sneeze with your mouth open: Keeping your mouth open when you sneeze or cough reduces pressure inside the sinus.
- Do not use straws, and stay away from smoking: The sucking motion and smoking can negatively affect healing.
- Avoid pressure changes: Wait for your dentist's approval before flying, diving or doing strenuous exercise.
- Cold compress: On the first day, applying cold to the cheek at intervals can help reduce swelling.
- Medications: Take the medications your dentist recommends exactly as prescribed; do not add or stop medications on your own.
- Diet and care: In the first days, choose lukewarm, soft foods and do not chew on the treated area. Continue your oral care as your dentist recommends.
If you experience worsening pain, increasing swelling, fever, foul-smelling discharge from the nose, or graft particles coming into the nose or mouth, contact your dentist without delay. For other questions about implants and bone procedures, you can take a look at our frequently asked questions page.
When should you get an assessment for upper jaw implants in Ankara?
If you have lost your upper back teeth and are considering implants in this area, not delaying the assessment too long can widen your options, since bone decreases over time after tooth loss. At our polyclinic in Oran, Çankaya, after three-dimensional imaging and an examination, we assess together with you whether a sinus lift is needed and, if so, which technique is suitable.
Frequently asked questions
Is a sinus lift a painful procedure?
Because the procedure is performed under local anesthesia, pain is usually not felt during it. Afterwards, tenderness, swelling and bruising lasting a few days may occur. In most cases these complaints are brought under control with the medications and care instructions recommended by the dentist.
Can a sinus lift and an implant be done on the same day?
If the remaining bone is enough to keep the implant stable initially, the implant can be placed in the same session. If there is very little bone, the sinus lift is done first, the graft is allowed to mature and the implant is placed in a later session.
Is a nosebleed normal after a sinus lift?
Slight bloody discharge from the nose may be seen in the first days and usually decreases quickly. If the bleeding is heavy or prolonged, or is accompanied by fever and foul-smelling discharge, you should see your dentist.
Can a sinus lift be done if I have sinusitis?
A sinus lift is generally not performed while there is active sinusitis. The sinus problem is treated first and, if needed, an ear, nose and throat specialist's opinion is obtained. Once the sinus is healthy, the procedure is reassessed.
