SINUS LIFT

WHEN YOU NEED SINUS LIFT?

Lifting or lifting the sinus is a surgical procedure specific to dental implantology that allows the addition of dental bone (bone addition) and the insertion of dental implants.

When for the reasons explained below the sinus goes down, the dental implant can no longer be placed in optimal conditions and due to this action the sinus lift procedure is used.

WHEN YOU NEED MAXILLARY SINUS?

Many people today are affected by lowering of the maxillary sinuses. If you are among them, you should know that this can have several possible causes:

• You have lost one or more molars or premolars (masses) in the past, and the bone in which their root is anchored has resorbed and no longer has the same volume.
• You suffer from a periodontal disease.
• Dentures have been used for many years
• The sinuses have increased in volume. This is normal and happens as you get older.

Also, some patients have an anatomy of the sinus that does not allow direct insertion of the implant, respectively it is too large. This situation differs from patient to patient because each of us is an individual.

WHY THE SINSUS GOES DOWN?

The maxillary sinuses are cavities inside the maxillary bone that communicate with the nasal cavity and are filled with air. These sinuses are close to the roots of the molars and premolars. What separates the maxillary sinuses from the roots of the teeth is a portion of bone of the order of a few millimeters.

On the other hand, due to the cranial anatomy, the back of the upper jaw does not have as much bone as we find in the lower jaw, so the roots of the teeth are even closer to the maxillary sinuses. This is true for anyone, regardless of age or gender.
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When you lose a tooth, that place begins to change. The lack of the tooth root makes possible the appearance of a deepening hole, and this means a loss in height and thickness of the bone in that area (the bone is resorbed because it is no longer stimulated by the tooth root).

In figure A you can see at the top a healthy (high) maxillary sinus. In Figure B, due to tooth loss, the sinus descends and fills the gap left by the bone that has decreased in volume.
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In this situation, in order to be able to insert an implant, we have to restore the amount of bone lost, but before that we need to lift the sinus as it was before, in the initial position. We can achieve this goal in two ways.

SINUS LIFTING METHODS

To bring the sinus back to the correct position we have 2 variants of sinus lift: internal and external.

The choice of procedure will be established by the surgeon who will ask you, together with the set of mandatory tests, a panoramic radiography and a computed tomography. This is necessary to determine the structure and bone density of the jaw.
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If the degree of bone resorption is high, the indicated procedure is the external one. In cases where there is enough bone, an internal sinus lift is applied.

INTERNAL

The first option called internal sinus lift is a minimally invasive procedure, so less painful, but can not be performed unless we have a bone thickness of at least 5-6 mm.

The operation begins with regular local anesthesia, then continues with penetration into the bone, pressing and lifting the sinus membrane, inserting the graft or bone powder into the recovered space and inserting the implant quickly.

ADVANTAGES AND DISADVANTAGES

When there are conditions for performing the internal sinus lift operation, there are the following advantages:

• it can be done in the same session with the addition of bone and dental implant, so you can have new teeth in one day.
• it costs less than an external sinus lift.
• impossibility to perform in cases of massive bone resorption.

EXTERNAL

External sinus lift is a recommended operation if the maxillary bone has resorbed in a very large proportion. This usually happens when, after tooth loss, a large number of years have been expected without dental implants being inserted.
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I hope, unlike the internal lifting method, the external sinus lift is done by penetrating and inserting the artificial bone through the lateral area and not perpendicular.

ADVANTAGES AND DISADVANTAGES

• recommended for cases of massive bone resorption.
• rarely can the dental implant be made in the same session. This condition depends on the amount of bone in existence. If the bone volume is too small, it is performed in 2 stages. In the first stage, the bone addition is made and it is waited 4-5 months for the material to osseointegrate. Only after this interval does he return to the clinic for the insertion of the dental implant.
• It costs more than the internal sinus lift.