Sinus Augmentation or Sinus Lift Procedure

The Sinus Augmentation of Sinus Lift Procedures are very common bone grafting procedures within the realm of implant dentistry.  Patients are often not quite clear what these procedures actually are, so I would like to

The maxillary sinus on a CT scan 3-D image

The maxillary sinus on a CT scan 3-D image

shed some light on these grafting procedures.  The maxillary sinus is the largest of all sinuses in the head-and-neck area.  It is located just to the inside of the bone in the upper cheek area.  The maxillary sinus starts out as a small air cavity in children and then expands and gets bigger as we grow older.  Once teeth are missing in the back areas of the upper jaw, the sinus will expand even further down towards the jaw ridge from the inside of the jaw bone.  This can be seen on the images on the right, especially the very bottom image, which shows a cross-sectional CT scan slice through the alveolar process of the upper jaw bone.

Now, as the sinus expands, and encroaches upon the alveolar ridge from the inside, you can appreciate that there is a diminishing distance of bone left between the top of the ridge and the floor of the sinus.  If this distance is too small to place one or several dental implants of proper length, we need to perform a sinus lift or sinus augmentation procedure, in order to re-gain this distance.

What is the difference between a “Sinus Augmentation” and a “Sinus Lift Procedure”?  Well, many will use these two terms

A CT Scan Slice through the sinus and alveolar process

A CT Scan Slice through the sinus and alveolar process

interchangeably, however there is a little difference between these two terms.  A “Sinus Augmentation” is a slightly more aggressive procedure, where a window is cut into the bony cheek side wall of the sinus and the sinus membrane is then gently lifted off the sinus floor, until a bone graft is finally placed underneath the lifted membrane.

A Sinus Lift procedure, on the other hand is usually performed right through the hole which is drilled for the implant(s).  No window is cut on the cheek side of the bone.  The Augmentation is usually done, for bigger lifts and the Lift procedure is usually done for smaller lifts.

So when the sinus membrane is finally lifted in either procedure, a bone graft is placed underneath the membrane, which keeps the membrane “tented” up.  For more detailed information on bone grafts see my bone graft post or link to Robert Gougaloff ‘s website.  This bone graft will then “mature” over the next six to 24 months (depending on the type of graft used).  What this

A CT Scan Cross sectional slice from the above image

A CT Scan Cross sectional slice from the above image

has accomplished however, is that the floor of the sinus was effectively “raised” and has thus given us enough room to place one or more dental implants of proper length.

Sinus Augmentations and dental implants can be done in one stage or in two stages, depending on how much residual alveolar bone was left to stabilize the implant.  If it is done in two stages, then the dental implant is usually placed 6 to 12 months following the sinus augmentation, depending on the graft material used.

Sinus Lift Procedures and the placement of dental implants are usually done at the same time, which obviously shortens the treatment time dramatically.  However this can usually be only done if the amount of lift needed is not too excessive.

A video of a Sinus Augmentation procedure can be seen on the following video link: Robert Gougaloff ‘s Sinus Augmentation Video.

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