Open and closed sinus lifting during dental implantation

For many patients, the sinus lift procedure (scientifically known as subantral augmentation) is essential before implant placement. However, not everyone understands what this entails. It allows patients to experience all the benefits of dental implants and expands the possibilities for creating a new smile.

Bone Tissue Atrophy

Often, extraction of upper teeth without subsequent defect restoration leads to bone tissue atrophy. The main issue is that this area contains anatomical structures in the form of maxillary sinuses, the floors of which may be too close to the socket of the missing tooth. As a result of atrophy, a thin layer of bone remains in the defect zone, behind which is a cavity. In such cases, open or closed sinus lift techniques are used.

Indications for Sinus Lift

The procedure is indicated for:

• Bone plate thickness less than 6-8 mm.
• Unique structure of the air sinuses.
• Significant atrophy after tooth extraction.

Sinus Lift in Dentistry

Sinus lift is a complex surgical procedure aimed at increasing the volume of bone in the upper jaw by lifting the sinus floor. As mentioned earlier, there are two types of this procedure: open and closed sinus lifts. Modern 3D imaging technology helps calculate all the necessary conditions and select the appropriate implant.

Open Sinus Lift

An open sinus lift involves thickening the floor of the maxillary sinus through an external approach. This requires creating an opening in the upper jaw. Specialized equipment is used in the process, and the method requires high skill from the surgeon. The steps include anesthesia, incision, peeling back the mucosa, creating a window in the sinus, and detaching the thin membrane lining the floor. The created space is filled with bone material, which can be taken from the patient's own body or consist of processed bone granules from animals. This way, the volume of tissue is increased, creating the necessary conditions for implant placement.

Closed Sinus Lift

A closed sinus lift involves accessing through the socket of the extracted tooth. After extraction, the membrane is detached through the bottom of the socket and filled with bone material, which locally increases volume and allows the implant to secure. This procedure is considered less traumatic compared to the open method, but the choice of technique depends on the specific case.

Such interventions require specialized tools. The materials used remain the same as for other bone augmentation procedures. Some specialists use special scalpels and blades to minimize trauma. For the open method, specialized drills and burs are needed for access to the maxillary sinus, while other consumables are the same as those used in implant placement.

Augmentation in Dentistry (Bone Grafting)

Augmentation (bone grafting) is applied not only to the upper but also to the lower jaw. There are now numerous methods available, and clinicians select the appropriate technique individually, based on the overall health condition and state of the oral cavity.

Many patients prefer simultaneous upper tooth implantation. If possible, sinus lift and implantation are performed in one visit. The titanium implant is placed into the augmented bone and secured, after which the implant integration phase begins. If simultaneous procedures are not feasible, a waiting period of 4-6 months is required, followed by a repeat of the 3D tomography to assess the results and make a decision about further implant placement.

Postoperative Recovery

Questions about recovery during the postoperative period often concern patients. The doctor provides individual recommendations, prescribes antibiotics, pain relievers, anti-swelling medications, and antihistamines. The medication and recommendations vary depending on individual characteristics and responses to the procedure. Pain and swelling may occur during the first week. It is important not to touch the stitches and to ensure rest for the recovery of blood flow in the affected areas. The gums may appear blue and swollen. The surgeon will alert you to potential complications, but any persistent discomfort should be promptly reported to the specialist. Serious complications can include infection of the surgical area and bleeding.

Bleeding can only be identified through personal sensations. If the taste of blood persists for an extended period, it may be a reason for a follow-up visit to the dentist. Additionally, in the postoperative period, it is essential to avoid sneezing and blowing your nose to prevent damaging the maxillary sinus membrane or dislodging bone material from the socket. Other recommendations include a soft diet, limiting physical activities (for 1-2 weeks), and avoiding flights. As with any surgery, it is crucial to refrain from harmful habits during the recovery period.

Before undergoing surgical intervention, it is important to understand the procedure, what to expect during the postoperative period, and the doctor's recommendations. A responsible approach to your health significantly enhances treatment success and eases the recovery process.