Sinus lift


Maxillary sinus floor augmentation[1] (also known as a sinus lift, sinus graft, or sinus augmentation) is a surgical procedure that increases the amount of bone in the posterior maxilla by lifting the Schneiderian membrane and placing a bone graft.[2]
After upper jaw tooth loss, the bone may shrink and the sinus cavity can expand into the space. Sinus augmentation restores bone volume, creating a stable foundation for dental implant placement.[3]
Indications
[edit | edit source]The main indication is to provide sufficient bone under the maxillary sinus for implants.[4]
Sinus pneumatization and bone resorption can follow long-term tooth loss, periodontal disease, or trauma.[5]
Candidates include:
- Loss of one or more posterior maxillary teeth
- Severe bone loss in the posterior maxilla
- Congenital absence of teeth
- Fully edentulous maxilla needing implants
Cochrane reviews report no clear evidence that sinus lifts are more effective than short implants in reducing implant failure.[6]
Technique
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Assessment is made with panoramic radiographs or cone beam computed tomography to evaluate sinus anatomy and rule out pathology.[7]
Lateral window technique
[edit | edit source]The lateral (traditional) approach creates a window in the sinus wall, lifts the membrane, and places graft material. Healing usually takes 4–12 months.[8]
Bone substitutes include autograft, allograft, xenograft, and alloplast.[9] Long-term success exceeds 90%.[10]
Osteotome technique
[edit | edit source]The osteotome method, developed by Hilt Tatum and later described by Robert B. Summers,[11] uses a transcrestal approach with osteotomes. It is less invasive but limited in augmentation. Implant survival remains high.[12]
Variations include the Localized Management of Sinus Floor (LMSF) technique[13] and use of electrical mallets to simplify transcrestal elevation.[14]
Complications
[edit | edit source]Reported complications include:
- Schneiderian membrane perforation
- Sinusitis[15]
- Infection[6]
- Inflammation[16]
- Pain, bleeding, or graft failure
Recovery
[edit | edit source]Bone healing generally requires 3–6 months, though implants can sometimes be placed simultaneously.[17]
History
[edit | edit source]The sinus lift was pioneered by Hilt Tatum in 1974 (Opelika, Alabama). Philip Boyne and R. A. James published the first reports in 1980.[18]
Cost-effectiveness
[edit | edit source]The transalveolar method is less costly and invasive, while the lateral window is more effective in severe cases.[19]
References
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External links
[edit | edit source]- OsseoNews.com – discussion on sinus lift procedures