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Sinus lift

Also known as: Sinus augmentation, Maxillary sinus floor elevation, Sinus graft

Elevation of the membrane lining the maxillary sinus so that bone height available for an implant in the upper back jaw can be increased.

Key facts

Surgical approachTwo approaches are described: the lateral window approach, which requires a bony window in the lateral wall of the sinus and is associated with greater post-surgical complications, cost and complexity; and the transcrestal approach, described as a blind technique with a small wound, short operation time and high patient satisfactionVerified spec[1]
Typical useA published decision tree uses residual crestal bone height: transcrestal is preferred at 6 mm or more; at 4–6 mm transcrestal is used if the sinus is healthy and lateral if it is not; at 2–4 mm the lateral approach is used where the lateral wall is at least 2 mm thick; below 2 mm the potential for membrane stretching must be assessed comprehensivelyVerified spec[1]
LimitationsPerforation of the sinus membrane is the characteristic complication; the review reports a 56.4% perforation rate where the lateral wall was 2 mm thick or more, falling to 12.1% where it was 1 mm or lessVerified spec[1]Rates are reported in relation to lateral wall thickness in the cited review and are not a general population figure
Graft materialsThe ITI consensus records that, in relation to sinus elevation, it is not clear whether the introduction of a grafting material improves the prognosisVerified spec[2]
Main stagesAssessment of residual bone height and sinus health on three-dimensional imaging; elevation of the membrane through either a lateral window or the implant osteotomy; placement of graft material where indicated; implant placement, either at the same time or after a healing interval, depending on how much bone was available to stabilise the implant.

Overview

A sinus lift raises the soft lining of the maxillary sinus and creates space beneath it for bone, because the upper back jaw often has too little height for an implant once teeth have been missing for some years. There are two quite different operations sharing the name: a lateral window, opened through the side of the jaw, which gives direct access and handles difficult anatomy; and a transcrestal lift performed through the implant site itself, which is far less invasive but is done largely by feel. Which is appropriate is driven mostly by how much bone remains — published decision trees favour the transcrestal route from about 6 mm upwards and the lateral window for the thinner cases. The characteristic complication is a tear in the sinus membrane, and its likelihood is strongly related to local anatomy such as the thickness of the sinus wall, which is one reason three-dimensional imaging is done first. It is also worth knowing that whether adding graft material improves the outcome is still not settled in the consensus literature.

This is general information. Whether any treatment suits you depends on clinical examination, including imaging — no website can determine that.

Sources

Numbers match the citations beside each claim above.

Clinical evidence

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