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What is a Sinus Lift Procedure?

There are air compartments within the skull, connected with the nasal passageways. These are called sinuses. Above the upper back teeth is the maxillary sinus (one on each side of the skull). When we wish to place implants in this area, sometimes there is insufficient height of bone available between the mouth and the (maxillary) sinus in which to place them. If this is the case, a Sinus Lift procedure is performed. The procedure is meant to cause the growth of more bone in the bottom of the sinus in order to hold the implants.

Below: xrays which are part of a CT scan, first of all providing a view from the side. The accompanying diagrams provide a cross-sectional view from in front (i.e. the right side of the drawing is towards the outer cheek side of the jaw and the left side of the drawing is towards the middle of the mouth).

 

Just as the bone in the mouth is covered by a layer of soft tissue called gums, there is also a soft tissue membrane covering the bone from the sinus side. As can be seen in the xray, there were only a few millimeters of height of bone- not enough in which to place an implant.
 

First an incision is made and the gum is peeled open just like a banana peel.

Then a small window is opened through the bone wall of the sinus until we expose the membrane lining the inside of the sinus.

 

 

With gentle pressure the internal membrane is peeled away inwards from the bone to make room for more bone.

Then we fill the space we have made between the membrane and the bone with a material which serves as a temporary bone replacement. It functions to prevent the membrane from falling back into its original position.

 

At this point the window in the bone is covered with a collagen membrane, which will resorb within a few months, and then the flap in the gum is closed back together

 

Xray in centre: six months after the sinus lift procedure: The synthetic material used as a filler is still visible (egg-shape).

On the right: subsequent to the placement of the implant. There is still a visible difference in appearance in the xray between the patient’s own bone and the graft (lighter shade)

 

 

6 months later:

A crown is now in place on the implant. A change is seen in the appearance of the graft, which now looks more like the surrounding bone, which is indicative of the patient’s own real bone growing into and replacing the graft.

 

This case is presented with grateful acknowledgement to my wife, Tami, who graciously and patiently went through the treatment necessary to produce these pictures!!