Sinus Lifts

A sinus lift, sometimes called a sinus augmentation, is surgery that adds bone to your upper jaw in the area of your molars and premolars to make it taller. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, the sinus membrane has to be moved upward, or "lifted."

What It's Used For?

A sinus lift is done when there is not enough bone in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed. There are several reasons for this:

• Many people who have lost teeth in their upper jaw — particularly the back teeth, or molars — do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw.
• Bone may have been lost because of gum disease.
• Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.
• The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus varies among individuals. In addition, the sinus can get larger as you age.

Sinus lifts have become common over the past 15 years as more people are getting dental implants to replace missing teeth.

Preparation

You may need X-rays taken before your sinus lift so the dentist can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.

How It's Done

Your surgeon will cut the gum tissue near your premolars and molars. The tissue is raised, exposing the bone. A small, oval window is opened in the bone. The membrane lining the sinus on the other side of the window separates your sinus from your jaw. This membrane is gently pushed up and away from your jaw. Granules of bone-graft material are then packed into the space where the sinus was. The amount of bone used will vary, but usually several millimeters of bone is added above the jaw.

Once the bone is in place, the tissue is stitched closed. Your implants will be placed four to nine months later, depending on the graft material that was used. This allows time for the grafted material to mesh with your bone.

Follow-Up

After the procedure, you may have some swelling of the area, and may bleed from your mouth or nose. You should not blow your nose or sneeze, because these activities can cause the bone-graft material to move, and can cause the stitches to loosen.

Your dentist may give you saline sprays to keep the inner lining of your nose wet and prescribe medication to prevent sneezing. If you have seasonal allergies, you should schedule the procedure when they are not active. You also will be given pain medication, an antibiotic and an antimicrobial mouthwash to help prevent infection. Most patients have only a little discomfort after a sinus-lift procedure.

You will see the specialist after 7 to 10 days to have the sutures removed, and for the specialist to see how you are healing. Your probably will be asked to return a few more times to make sure the area is healing properly.

After a sinus lift, you need to wait several months for the bony material to harden and integrate with your jaw. Once this happens, the implants will be placed.

Risks

The main risk of a sinus lift is that the sinus membrane could be punctured or torn. If the membrane is torn during the procedure, the surgeon will either stitch the sinus tear or place a patch over it. If the graft material cannot be contained, your surgeon may stop the procedure and give the perforation time to heal. Your dentist can redo the sinus lift once the membrane has healed, usually a few months later. A healed membrane tends to be thicker and stronger, which means a second attempt at a sinus lift is likely to be successful. However, other factors also affect success.

Infection is a risk of any surgical procedure. However, this rarely occurs following sinus lifts.

On rare occasions, your existing bone does not integrate with the bony graft material, and the grafted area does not develop a blood supply. If this happens, any implants placed in this area will fail because there is no live bone for them to attach to. If this happens, you can have the sinus lift procedure repeated.

Full Mouth Rehabilitations

This is the process by which all the teeth in the mouth are treated to conform to a predesigned bite to restore function and aesthetics.

Why is it necessary?

The teeth and gums can be effected by one or more of three main disease process:

• Dental decay
• Gum disease &
• Tooth wear due to grinding, acid erosion or a combination of these

The consequences of all the above are either damage to the teeth or tooth loss. In most people these diseases are diagnosed early enough to treat conservatively ie with fillings, crowns, gum treatment dentures etc, which forms the main activity of most dental practices.

Unfortunately, in some instances the problems may be diagnosed too late, by which time severe destruction and tooth loss may have taken place, resulting in discomfort, inability to chew properly and poor aesthetics. In these instances, a holistic approach has to be taken with regards to the management of the problems and reconstruction of the teeth and smile.

What is the treatment?

The treatment varies with every case and is dependent upon the causes of the problems, the patients expectations, the ability of the treating surgeon and also financial implications.

The main challenge with these types of cases is that it involves much in-depth treatment planning from the outset and the amalgamation of several specialities within dentistry to tailor a solution that is appropriate for you, in other words a “multi-disciplinary approach”.

What to do next

If you feel that your teeth have been affected as described above, we would welcome you to have a chat with Dr Parmar to discuss your concerns.

Examples of rehabilitation's carried out at AIDP

Coming soon...