Many people are missing teeth in the upper jaw, particularly molars. This area already has less jawbone mass, but when a tooth is missing the jawbone tends to deteriorate (resorb). This is because teeth transfer the intense energy created by biting and chewing down through the teeth into the jawbone beneath them. This energy triggers the jawbone to continually build new jawbone mass, shedding old cells and replacing them.
Without this energy coming through the tooth (which is missing), the jawbone begins to immediately resorb/deteriorate. Bone loss can also be due to periodontal disease.
A sinus lift/augmentation surgery is necessary to add bone mass to the upper jawbone. Once the sinus has been lifted and bone-grafting material placed, the jawbone will become thicker/higher. This will provide adequate jawbone mass to fully support the implants screwed into it.
The procedure begins by opening the gum tissue where the patient’s back molars used to be; this exposes the bone. Next, a small hole is made in the upper jaw to access the sinus. There is a membrane lining the sinus separating the jaw from the sinus. This membrane is gently pushed up and away from the jaw.
Next, a bone-grafting material is packed into the space where the sinus was. In most cases, the goal is to add several millimeters of bone height.
Once the bone graft is in place, the tissue is closed with sutures, and the procedure is finished. The bone needs to grow for 4-9 months, depending on the individual, before it will be sufficient to support the implants.
You will likely have some swelling around your nose and upper lip area. You may have some bleeding from your mouth or nose. It’s critical that you not blow your nose or sneeze through your nose for one month. This can cause the bone-grafting material to move, and it can loosen your stitches.
We’ll provide you will saline spray to keep the inner lining of your nose wet. We’ll also prescribe antibiotics, an antimicrobial mouthwash, and medication to help with inflammation and congestion. This isn’t an overly painful recovery.
You’ll see us periodically to check on the progress of your healing and then your bone growth. If everything progresses normally, in 4-9 months we can start your implant process on the road to having upper molars again.
The main risk with this procedure is a puncture of the sinus membrane. If this happens, the membrane can be stitched back together or the hole may be closed with a patch.
The other risk is that the existing bone doesn’t integrate with the bone-graft material. If integration doesn’t happen, the bone won’t have a blood supply, so the new bone is not alive and functioning.
If this happens, the implant will fail. A sinus lift would then have to be performed again. Infection is not a much of a risk with this procedure.