SINUS LIFT
WHAT IS A SINUS LIFT?
If you are missing molar (back) teeth in the upper jaw, you may choose to replace these with dental implants. The success of a dental implant is partly based on the amount of bone in this region. If you have enough bone, you will not need a sinus lift. However, loss of teeth in this region may, over time, cause bone loss.
A sinus lift is a surgical procedure that is performed to increase the amount of bone in the area of the upper molar teeth. Sinus lifts are performed before a dental implant/implants are placed in this region if there is not enough bone in the region within which to place a dental implant/implants.
Missing bone in the region is replaced with bone-substitute.
WHAT IS THE SINUS?
The sinus that your dentist and I specifically refer to when discussing a sinus lift is the maxillary sinus. You have two maxillary sinuses - one on the right side and one on the left side. The maxillary sinuses are air hollow air spaces. The inner surface of the maxillary sinus is lined by a thin lining of tissue called the maxillary sinus lining. The exact function of the maxillary sinus is unknown, but it is thought that they play a role in removing debris from the air that we breathe and as a shock absorber for trauma to the head.
WHAT INVESTIGATIONS WILL I NEED BEFORE MY TREATMENT?
You will need an x-ray before your sinus lift.
A 2D x-ray will show the amount of jaw bone remaining in the region of the upper molar teeth. However, this provides limited information regarding the 3D structure of the sinus.
As such a 3D scan will also be required. The 3D scan will provide greater detail of the shape of the sinus and its relationship with teeth and anatomical structures that are close to the area.
HOW WILL MY SINUS LIFT BE PERFORMED?
Before I perform your sinus lift, I will apply numbing injections in the gums around the site. I will then leave this for 5 minutes for the anaesthetic to work.
I will check that the anaesthetic has worked by pressing around the affected area using a dental probe. At this point, you will feel pressure but you should not feel pain. If you feel pain, I will leave more time for the anaesthetic to work or apply more anaesthetic depending on what you can feel.
Your surgery will only start when you are happy that you are numb. The gums around the jaw bone will be opened with a small incision. The sinus lining will then be accessed by creating space in the bone. Once the sinus lining can be seen, it will be pushed upward. A bone substitute will then then be placed below the sinus lining.
Once your sinus lift has been performed, opening in the gums will be closed with stitches. The stitches will dissolve 10 - 14 days after your surgery.
WHAT IS THE BONE SUBSTITUTE USED TO REPLACE THE MISSING BONE?
There are a number of bone substitute used to replace the missing bone during a sinus lift.
Usually this bone substitute is bovine (cow) derived. The bone substitute has all of the mineral content removed from it and is sterilised. As such, no bovine element remains in the bone substitute.
Your body's own bone cells use this bone substitute as a scaffold upon which to grow and replace the missing bone.
Bovine-derived bone substitute has a long, well-established track record of safety for use in humans.
WILL I BE AWAKE DURING MY SURGERY?
Sinus lifts are performed under local anaesthetic or intravenous conscious sedation.
Treatment under local anaesthesia only numbs the gums around the area. You will be awake throughout your treatment, but you should not feel any pain or discomfort.
Intravenous conscious sedation is administered through a vein in your arm or hand. However, this is not the same as a general anaesthetic which will put you completely to 'sleep'. Instead, intravenous conscious sedation will reduce your awareness of the procedure. The treating team will still be able to speak with you and identify if you are feeling discomfort.
During your consultation I will discuss the advantages and disadvantages of treatment under both local anaesthetic and intravenous sedation at greater length.
WHAT WILL MY RECOVERY TIME BE AFTER MY SINUS LIFT?
You may experience pain, swelling and bruising after your sinus lift?
Pain usually worsens over the first 3 days after surgery. This may take up to a further 10 days to stop, with daily gradual improvements. Provided that you have no allergies, intolerances or reasons why you cannot take them, the following painkillers are advised:
Paracetamol 1g every 6 hours for 7 days
Ibuprofen 400mg every 8 hours for 7 days
I will confirm with you which are best in your case.
Swelling usually worsens over the first 3 days after swelling. This may take up to a further 10 days to disappear, with daily gradual improvements. You may use an ice-pack applied to the outside of the face for 15 minutes in the morning and in the evening to help to reduce the swelling.
Bruising after a sinus lift is common. This will usually resolve with any swelling that you may experience.
You may also experience an intermittent nose bleed for up to the first 72 hours after surgery. This is less common and usually stops over time.
You will also require antibiotics after your surgery, which I will prescribe depending on which is most appropriate.
WHAT CAN I EAT AFTER MY SINUS LIFT?
Immediately after your surgery while you are still numb, avoid hot food and drink to prevent burning yourself without realising.
Once the local anaesthetic has worn off, you will find a soft diet for the first 3 days after surgery more comfortable. If you feel that you can return to a normal diet you may do so.
Avoid small grains and pieces that may cause trauma to the surgical site for 5 days after your surgery.
Avoid alcohol for the first 48 hours after your surgery.
Avoid smoking for at least 72 hours after your surgery - the longer you are able to stop smoking the lower the chances of infection.
CAN I BRUSH MY TEETH AFTER MY SINUS LIFT?
You should return to toothbrushing as soon as possible after your sinus lift. Ideally you should start on the same evening as your cyst removal.
You should resume mouthwashing with mouthwash or saltwater as soon as possible after your sinus lift surgery.
DO I NEED A REVIEW AFTER MY SINUS LIFT?
Once your sinus lift has been performed, the site will be left for at least 3 months before further treatment.
Prior to implant placement, your dentist will arrange further review with you. You will also likely require a 3D scan to review the healing in the region before implant placement.
ARE THERE ANY OTHER TREATMENT OPTIONS?
A sinus lift is only required if you have insufficient bone in the upper molar region and you wish to replace missing teeth in this region with dental implants.
You may choose to replace missing teeth by other means including dentures or a bridge. Your dentist will discuss all treatment options to replacing teeth before referring you for sinus surgery.