The maxillary sinus always has to be considered primarily while placing dental implants in the posterior part of upper jaw. Many times maxillary sinus floor escallops around the roots of maxillary premolar and molar teeth. This happens particularly with maxillary first and second molars. Because of this, during extraction of these teeth, there may not be sufficient bone height available for supporting dental implants in posterior maxilla and here sinus lift procedure to the maxillary sinus floor is required.
For sinus lift procedure, a small window is created in the anterior wall of the sinus using special burrs. These burrs cut a window in bone but do not cut the underlying tissue. Thus the window is cut safely without any damage to the sinus membrane. Next, the sinus membrane is lifted carefully. Usually a resorbable collagen membrane is positioned in the sinus against the membrane to safeguard the sinus membrane while the bone graft material is positioned atop the maxillary sinus floor.
There are various types of bone graft materials available for a sinus lift, including autogenous bone (patient’s own bone), bovine bone (cow bone), allogenicbone (frozen and dried cadaver bone) and BMP (bone morphogentic protein). The graft takes usually 6 months to heal and after that the implant can be placed safely on to the grafted sinus.
An ICAT scan or a cone beam scan used in sinus lift is an in-office CAT scan machine which enables the dental surgeon to see the bone in a three-dimensional form. This enables the surgeon to measure the height and width of the bone. This is particularly useful while evaluating the posterior maxilla to decide whether there is sufficient bone for positioning dental implants. With the map of the existing bone, the surgeon can decide whether the area requires a sinus lift or bone graft so as to facilitate dental implants.
The aim of a skilled dental surgeon is to minimize the number of surgical procedures and to maximize aesthetic results. If possible, along with extraction of teeth, placing an implant and finishing a simultaneous sinus lift or mini sinus lift can be performed in the same surgery. But sometimes it becomes essential to do two individual surgeries – first to extract the teeth and do sinus lift and the second to place dental implants. These procedures are usually done under IV sedation so as to make the patient asleep, relaxed and comfortable for the surgeries.
A secret of getting success in dental implants is in placing the implants into a right bone foundation. In a condition where there is no sufficient bone is available for this, a sinus lift enables the dental surgeon to place it successfully in the posterior maxilla.