Sinus lift

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X-ray showing a sinus lift in the left upper jaw
Sinus lift surgery, 3D illustration

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

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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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Stages of a lateral window sinus lift procedure

Assessment is made with panoramic radiographs or cone beam computed tomography to evaluate sinus anatomy and rule out pathology.[7]

Lateral window technique

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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

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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

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Reported complications include:

  • Schneiderian membrane perforation
  • Sinusitis[15]
  • Infection[6]
  • Inflammation[16]
  • Pain, bleeding, or graft failure

Recovery

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Bone healing generally requires 3–6 months, though implants can sometimes be placed simultaneously.[17]

History

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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

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The transalveolar method is less costly and invasive, while the lateral window is more effective in severe cases.[19]

References

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