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Direct sinus lift

What is Sinus Lift?

Direct Sinus Lift is also known as Maxillary sinus floor augmentation, sinus graft, and sinus augmentation or sinus procedure. It a surgical procedure that is performed on patients to increase the amount of bone in the upper jawbone (the area of the premolar and molar teeth) where the lower sinus membrane is lifted and the bone graft is placed.

When the patient loses a tooth then the alveolar process begins and the empty tooth socket collapses as it heals leaving a toothless area, termed a ridge. The surrounding bone loses its height and weight and the floor of the maxillary sinus expands which again diminishes the thickness of the underlying bone.

All this results in the overall loss in volume of bone and the dental implantation will be affected. The goal of the sinus lift is to graft extra bone into the maxillary sinus, so that more bone will be available to support a dental implant.

What is Direct Sinus Lift?

Sinus Lift can be performed using different techniques and Direct Sinus lift is one such technique. It is also called Lateral Antrostomy, which is a two-step procedure. Sinus grafting is recognized as one of the effective treatment procedure with high implant survival rates.

This technique involves opening a lateral window in the bone and elevating the sinus membrane from the inferior aspect of the maxillary sinus. The graft material is then placed between the membrane and the interior wall of the sinus. 

Once the lateral opening is made and access to the sinus is achieved, using a blunt dissection the sinus membrane is carefully separated from its bony attachment. The membrane is carefully elevated to allow space for the placement of graft material between the membrane and the bony sinus floor.

The dental surgeon usually takes good care so as not to interfere with sinus drainage and tear or perforate the membrane. This technique continues to be the most popularly used method.

When is this Procedure needed?

There might be a number of reasons for the need for a greater volume of bone in the posterior maxilla. The most common reason in dental treatment planning is to prepare the site for the placement of dental implants.

This procedure is usually performed when the sinus floor is close to the area where the dental implants have to be placed and patients with the following conditions are also liable to get this procedure done.

  • When more than one tooth is lost in the posterior maxilla.
  • When there is a significant amount of bone loss in the posterior maxilla.
  • When there is a birth defect.
  • Need for a strong sinus floor for multiple implants.

Before undergoing sinus lifts, examinations are carried out to determine the health of the patient’s sinuses.

The Procedure

  1. Edentulous area of two missing teeth is examined for future placement of dental implants.
  2. The soft tissue is flapped back to expose the underlying lateral wall of the maxillary sinus.
  3. A Piezoelectric instrument is used to remove the bone, exposing the underlying sinus membrane, which is the lining of the maxillary sinus cavity.
  4. The membrane is carefully peeled from the sinus cavity’s inner aspect through careful instrumentation.
  5. The membrane once peeled off; exposes the bony floor of the sinus cavity without its lining membrane.
  6. The newly formed space is grafted with human cadaver allograft bone making the sinus floor roughly 10mm higher than earlier, allowing enough space for placing dental implants into the edentulous site.

Authored by DR.NIRANJAN P



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