The maxillary sinuses are located on the right and left sides of the skull at the level of the nose and above the maxillary molars. Its main function is to reduce the weight of the skull and produce mucus.
With tooth loss, aging, or congenital causes, sometimes this sinus membrane hangs down and the bone volume decreases. When the bone height falls below 4 mm, it is not possible to install implant the missing tooth area. Although 4mm long implants can be applied in the lower jaw molar region, 10mm or larger implants should be used in the upper jawbone as the upper jawbone is generally softer and of poor quality.
In this case, the process of lifting the sinus to create a bone area for the implant is called sinus lifting. Sinus lifting operation is performed in two ways, open and closed.
In the open sinus lifting operation, the sagging membrane can be raised more than the closed technique by entering laterally from the gingiva above the molars. First of all, under local anesthesia, an incision is made in the gingiva, extending from the premolar region to the back, and the upper jaw bone is reached. By opening a 3-5 mm window on the gingiva on the bone, the sinus membrane under the bone is reached. With the intervention performed through this small window, the base of the sinus membrane is gently scraped off the bone, released and pushed upwards. If there is not enough bone tissue in this opened space, bone powder is added and artificial bone tissue is created in the area. This process is called bone grafting. Then the surface is covered with a membrane and the opened wound is closed with small sutures.
Post-operative bone formation and healing process takes an average of 4-6 months. In this process, your body melts the added bone on the one hand and creates new bone on the other. In cases where the sinus floor and the maxilla ridge are more than 4 mm, both lifting and implant placement can be performed in the same session. This saves an extra 3 months for the patient.
The closed sinus lift technique is applied to increase the height by 1-2 mm in cases where the bone height is more sufficient. Generally, with hand tools called osteotome and hammer, the bone in the area under the implant is pushed with small and rhythmic movements and the sinus is shifted higher.
Which means the Sinus lifting and Bone grafting treatment usually plays a part in a full mouth treatment package including installing implants on patients who have been missing upper molar teeth for a long time rather than performing as a separate treatment.