Sinus Lift Bone Graft Basics

One common type of bone replacement graft is called a Sinus Lift Bone Replacement Procedure. It was invented in the 1970's by Dr. Hilt Tatum.  In fact, I have had the great honor and privilege to be trained by Dr. Tatum himself!  I have spent time in his home in France.

Procedure 1. “Lateral Window or Traditional Approach”

This common procedure and relatively painless procedure is only used to replace upper back teeth. The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

There is a solution and it’s called a sinus bone graft or sinus lift. In this common procedure we enter the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and about a teaspoon of bone is inserted into the sinus. In many cases, the implants are placed at the same time. After several months of healing, the bone becomes part of the patient’s jaw and teeth can be placed on the implants.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can often be performed as a single procedure. If the bone is very thin, the sinus bone graft will have to be performed first, and then the graft will have to mature for a few months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

Procedure 2. Internal Sinus Lift Procedure

This procedure is used when the bone loss of the upper back tooth area is minimal. In this minimally invasive procedure, the sinus bone is actually moved up through the implant site at the same time the implant is placed.

It is also possible to lift the sinus bone at the time of extraction of an upper molar in anticipation of a future implant. Bone replacement materials, if even necessary can be added through the tiny implant socket. Consult me before you have an upper molar extracted as we can probably save you time and money.


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5 thoughts on “Sinus Lift Bone Graft Basics

  1. James groves

    Dr Amin, I am concerned about my wife’s implants ,can only three implants in lower jaw be enough to support a 12 teeth fixed denture ,worried husband ,Jim groves.

    Reply
    1. Ramsey Amin DDS

      Hi James,

      Three implants is not enough. You have to engineer implants in a similar fashion to how God designed your natural teeth. We have may more than three roots per arch.

      If you don’t design strength, you will not have longevity. This is not an area to skimp on, unless you are looking for problems.

      If you are talking about a snap on over denture that you remove then that is a different story.
      Snap In Dentures on Dental Implants – Burbank Dental Implant Specialist

      Dr. Amin

      Reply
  2. David Sacks

    Dear Dr. Amin,
    Thank you for maintaining this blog. I recently had sinus lift surgery where a lateral window was cut in my maxillary sinus. A membrane was placed but now, 18 days post surgery there seems to be a be a bulge of bone graft material on the bucchal side of my gums associated with a moderate about of purrulent exudate which comes out every time another piece of grafting material works its way through the gum or to the margin of the tooth and gum. I understand that not every piece of bone will make it into the sinus but I have already lost 40-50 of these pieces and by the size of the cylindrical bulge which is about 2 cm long and
    and about 4-5mm in diameter I estimate that there could be 300-400 more of thes pieces in that bulge. I know you said that losing graft material is very common, but is it common to get a bulge of this much material? If this happened in your office would you go back in and replace the bone that didn’t make it into the sinus or would you just let it work its way throught the gums over time hoping that you’ve retained enough bone in the sinus?

    Reply
    1. Ramsey Amin DDS

      Hello David,

      The process you’re describing would not be considered normal. It would not be considered normal for a lateral window sinus bone graft to be losing bone (if that is truly the procedure you had done)

      It would be considered normal for a socket bone preservation graft for a dental implant to lose some bone particles.

      I hope you’re not wearing a temporary over the top that is rubbing on the lateral window access which can cause an opening in the gums. If you aren’t that area should be relieved tremendously to allow space so that a removable denture does not rub in that area. I would see your dentist ASAP. How is the situation now?? I realize I am replying about 5 days after your initial post….sorry!

      Please reference your original post by cutting and pasting when you do reply so that I do not lose this thread.

      After Extraction and Bone Graft…The Bone is Showing. Now What? Ramsey Amin, DDS Reviews Options

      example video of the sinus

      Very respectfully,

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      Reply