The sinus lift procedure in dentistry — what is it?
The sinus lift procedure in dentistry has been used successfully for over 30 years, although many people still do not know what it is? More accurate is the name «subantral augmentation», but because of its complexity, it did not stick, so even the doctors called the operation the sinus lift.
Augmentation — the most common procedure for bone augmentation in dental implantation. A large number of people who plan the installation of implants in the upper jaw, the need for such surgical intervention.
The essence of the operation
The structure of the maxillary bones is unique and differs significantly from the structure of the lower jaw. It is lighter due to the porosity. In the projection of the lateral root tips of the upper teeth is the maxillary sinus, the largest of all the sinuses of the skull. Thanks to her, is the warming of the inhaled air, resonating in the voices and reducing the weight of the skull.
The bottom side of the sinus is too thin, and sometimes the roots of the teeth are lodged in the sinus cavity. After removal of the formed oroantral fistula, causing lost vacuum in the cavity, there is a snuffling, mouth food enters the nose, is an infection of the maxillary sinus. In this case, no operation is necessary.
The second reason is the installation of implants. For them secure the required thickness of the bone. It is insufficient for two reasons:
- Anatomical feature of the structure of the upper jaw.
- Atrophy of bone tissue after tooth extraction.
Reduction of bone volume occurs in the absence of load on the edentulous area, in addition increasing pneumatization sinuses, which adversely affects the thickness of the upper jaw.
What is the sinus lift procedure in dentistry?
Augmentation of the mandible refers to the implant surgery. Today in the Arsenal of surgeons a broad range of techniques to build the bone structure. In addition to the sinus lift procedure these include autologous and the method of building bone blocks.
By increasing the thickness of the portion of the jaw between the root tips of the teeth and the bottom wall of the sinus to provide sufficient space for fixing the implants. The more the bone volume, the safer is retained titanium screw in the edentulous area.
The load in the lateral parts of the jaw is high, so there is often a need of installation of implants of 10 mm length, which will ensure its reliability and good resistance to mechanical stress.
In dental practice apply two methods of conducting bone augmentation:
► Open sinus lift (performed in the bone thickness is less than 7-8 mm)
When open surgery incision is made in the mucous membrane from the oral cavity, after which the cutter is drilled a hole to the inner wall of the maxillary sinus. After the lifting of the mucous membrane lining the maxillary sinus, the cavity compacted transplant material. To avoid germination of the epithelial layer it is covered with a barrier membrane and sutured mucous flap.
► Closed sinus lifting (carried out in the presence of bony structures from 8-10 mm or more)
Closed sinus lift refers to a more gentle procedures. Under local anesthesia of the lateral is cut a window through which is injected a special tool for detachment of the mucous membrane. At this stage it is important to maintain the integrity of the shell. After exfoliation in the cavity between the bone and the lining of the sinus osteoplastic placed chips, then superimposed seam on the soft tissues from the oral cavity. Often immediately after augmentation is the insertion of implants.
The choice of the method of operation affects the condition of the maxilla and maxillary sinus that is installed with the help of x-ray pictures, computer tomography and clinical examination methods.
There are conditions and diseases in which the implementation of osteoplastic operations are prohibited. These conditions include:
- malignant neoplasms;
- disorders of blood coagulation;
- diseases of the cardiovascular system in the stage of decompensation;
- disorders of the immune system;
- acute sinusitis of the maxillary sinus;
- the recovery period after surgery in the nasal cavity and maxillary sinus.
What can be complications and how to treat them?
There are the most common complications after sinus lift. Subject to equipment operation provided the work of highly qualified specialists and a full examination of the patient before augmentation, the likelihood of unpleasant consequences after the operation is low.
All complications are divided into two categories: those arising during the operation, and manifested during the recovery period.
During the operation:
- perforation of the mucous membrane of the maxillary sinus is the most frequent complication that occurs in 30% of operated patients. This happens due to the bad review of the surgical field and the reduced thickness of the mucosa, but it is easily correctable. For defect elimination is used suturing the mucous flap or closure of the perforation. For this purpose membrane, rassassyvesa cellulose and freeze-dried demineralized bone material;
- disruption of the surgical intervention, due to insufficient experience of the surgeon. When equipment failure occurs the penetration of infection in the area of open wounds. To resolve will require antibiotic therapy;
- anatomical features that complicate the quality of implementation of the sinus lift.
Postoperative complications are also a sizeable group. It is important to understand that with a good immunity and the condition of the patient, the risk is minimal.
- the absorption of the material and lack of recovery of the bone structure. If so, then you must repeat the operation with the use of other osteoplastica;
- exacerbation of chronic sinusitis – rare, requires the undertaking of measures on elimination of sinusitis;
- the luxation of the implant, the mobility due to poor implantation of the titanium screw or the development of peri-implantitis.
Failure to observe the stages of the sinus lift procedure in dentistry, in the postoperative period may develop bleeding, inflammation, formation of oroantral fistula.
To eliminate the nasty consequences you need to contact the doctor who performed the surgery. You should act quickly because even a day or two may play a role and lead to the need for repeated surgery.
The doctor will prescribe tests for the determination of the sensitivity of microflora to antibacterial drugs and based on these data, choose the best medicine. When infection of the sinus and the occurrence of fistulous may require washing of the cavity.
Advice and tips in the postoperative period
The time during which occurs the delay of the postoperative wound is 6-7 days. For quick healing of the soft tissues using the blood plasma of the patient, since its use prevents the risk of inflammatory complications.
To exclude all possible negative effects of the operation, you must follow these rules:
- not flying in the rehabilitation period;
- the first few days after surgery to rule out serious physical activity to prevent development of bleeding;
- not to perform any sudden movements, do not go swimming or Jogging, not to climb on higher floors;
- coughing and sneezing must be carefully, not forcing the action at the same time to keep the mouth open so as not to create a vacuum in the maxillary sinus, which is able to provoke the displacement osteosynthetic material;
- eat it hot because of the possible bleeding;
- to drink liquids in small SIPS, to exclude drinking through a straw.
The whole recovery period it is important to follow medical recommendations for the care of the postoperative wound and the oral cavity, and also to adhere to the assigned diet. These tips will help to prevent displacement of osteoplastic material and ensure that it is a good engraftment.
Video: be the operation of sinus-lifting?
Sergey, 29 years old
«I have no 2.4 and 2.5 of the teeth. It brought a lot of inconvenience, therefore, it was decided to place dental implants. After studying the images, the doctor said that you need to perform the sinus lifting. He explained what it was, then I agreed to the surgery. All took place under local anesthesia, but I didn’t have pain. In addition to bone augmentation implants was recorded, and then sent me home. Several times I went for a check – everything was fine. It’s been over a year since, I have no complaints, implants are hard».
Irina, 44 years
«When you remove the top of the sixth tooth has been pushing the root into the maxillary sinus, which formed a message. The doctor told me about the incident and was prescribed a course of antibiotics and told about the necessity of closing holes. The operation was conducted the next day. The whole healing period I often went to the doctor to avoid complications. All was well, so after a couple of months in place of the removed tooth implant I put. I am glad that there are no problems with a bosom.»
Peter, 35 years
«When it’s time to change the bridges on the new doctor, looking at my x-ray, said the bone is very small and without sinus lift surgery to put the implant impossible. I trust my doctor, so I agreed to the surgery. A couple of days I had my wound was slight edema. But it’s been three months since I smile with new teeth, and nothing’s bothering me».
► What is the cost of the operation?
The cost of conducting is different in each medical center. It depends on the skill of the doctor, the company used osteoplastic materials, and status of the clinic. Dentistry of Moscow to perform the operation of the closed sinus lift will cost 12000 – 15000 rubles. Open sinus lift is more expensive, the average cost is 25000 – 27000 RUR.