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Indirect Sinus lift

What is Sinus Lift?

It is a dental procedure that is performed to augment the amount of bone in the patient’s upper jaw, the area of the pre-molar and molar teeth. The dental surgeon performs this by placing a bone graft after the lower sinus membrane has been lifted. This procedure is also known as Maxillary Sinus Floor Augmentation or Sinus Graft or Sinus Augmentation.

When a patient loses his/her teeth, the alveolar process begins where the empty tooth socket collapses when it starts healing, leaving a toothless area that is termed as a ridge. This collapse will cause a loss in both the height and width of the surrounding bone. The maxillary sinus will then expand that will diminish the thickness of the underlying bone again.

This brings about a loss in the bone volume, which can, in turn, affect dental implantation. The sinus lift will enable the grafting of the extra bone into the maxillary sinus so that more bone will be available for the support of a dental implant.

What is Indirect Sinus Lift?

Different techniques are widely used to perform the Sinus Lift procedure. However, the factors that contribute to the survival rate of sinus augmentation and dental implant placement are still a topic under discussion.

Indirect Sinus Lift also called the Crestal approach technique is one such technique. This technique provides a bone height of nearly 4 to 6 mm. This procedure is usually recommended only when the residual bone thickness of more than 5-6mm is present and only an increase of a few mm is required.

When is this Procedure needed?

The atrophy or decline of the alveolar crest and the pneumatization of the maxillary sinus limits the quality and quantity of the residual bone. This development further complicates the placement of the dental implants in the posterior maxillary area.

The need for increased bone volume has led to the development of maxillary sinus augmentation techniques. The indirect Sinus lift or the Osteotome technique is usually performed as a lesser invasive procedure.

This procedure will help in stimulating bone growth and can help in thickening the sinus floor, which in turn can help support dental implants for teeth replacement.

The Procedure

In the Osteotome technique, the gum tissue is flapped back and a socket in the bone is made within 1–2 mm short of the sinus membrane.

The Osteotomes are used to lift the floor of the sinus by tapping it. The amount of height achieved with the Osteotome method is usually less than what can be achieved with the direct sinus lift technique.

During this sinus lift, the dental implant is then placed in the socket and then it is left to integrate with the bone. The bone might take around 4 to 8 months to integrate.

Today with advancement in instrumentation in sinus lift procedures, non-osteotome techniques that do away with the tapping of bone are becoming popular and more patient-friendly.

Use of specific kits to breach the sinus floor and lift it, help in making the procedure safer and comfortable.

Advantages of indirect sinus lift:

The indirect techniques have a number of advantages:

  • The surgery is more conservative
  • Localized sinus augmentation
  • Lower rate of postoperative morbidity
  • Shorter time needed to implant loading when compared with the direct technique
  • 90% survival rates are obtained.

Authored by DR.NIRANJAN P



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