Dentists and their patients often face a situation where after the loss of teeth in the lateral regions there is no longer enough jaw bones to install the implants. Although other cases are possible, the lack of bone is usually manifested by increasing sinus cavities, which occurs due to loss of teeth. In this case, installation of implants can not be done because dental implants inserted in such bone would penetrate into the sinus cavity without being able to strengthen their place in the bone. However, this does not mean that in such a situation implants can not be embedded, but only that it is necessary to take certain steps to ensure support for future bone implants.
A sinus lift is a procedure of bone compensation that involves raisingmucosal sinus andfilling the empty space with an artificially bone material.
First step – marking sinuses on the left and right side on which it is necessary to perform a sinus lift
This operation can be done in two ways. A simpler version of sinus lifts is applied when it is necessary to pick up the bottom of the sinus for 2-3 mm, and the procedure is called crestal sinus lift.
Through the opening that was made for the implant tray, mucous membranes of the sinus are slightly raised and then inserted a smaller amount of artificial bone with immediately installed a dental implant. This procedure is performed as part of the implant procedure. The patient does not have a different feeling nor the procedure takes more time than in case of standard installation of the implant into the bone, where compensation mass is not necessary. This sinus lift procedure is performed routinely, and has no complications or need to repeat the procedure.
In cases where the analysis of 3D panoramic radiographs finds that the distance between mouth and sinus bottom is 1-4 mm, crestal sinus lift can not be performed, but it is necessary to take a classic sinus lift with lateral access. What does that mean in practice?
A lateral approach involves creating a small “window” on the side of the upper jaw, which is then used to raise the sinus membrane and to insert artificial bone in the sinus cavity. Current research shows that it is the best to use a mixture of half of the artificial bone and half from the patient’s own bone (it is a small amount of bone that is “borrowed” from any bone of the patient, where they will soon grow back). Also, such a combination of artificial and natural bone provides the best results for the formation of new healthy bone in the sinus cavity.
After filling the sinus cavities patient has a sufficient amount of bone mass.
Installing of dental implants is done simultaneously with sinus lift surgery, which significantly shortens the time needed for making dental crowns and for full completion of treatment. If you act in this way, after six to eight months there will be new bone formation thus the success of the operation will be unambiguously confirmed and will then be immediately possible to make the only visible part of the implant procedures – dental crowns. Of course, sometimes it is not possible to install dental implants simultaneously with the replacement of the bone, so the implants are installed after six to eight months after, when we confirm that there is enough bone, but in this case, it is necessary to wait for an additional four months to strengthen the implants before making and incorporate crowns.
This type of sinus lift procedure leads to larger swelling, so you will need a longer recovery, but it is still one of the most successful ways of installing artificial bone, where complications occur only in very few cases.