Following teeth lost , the jaw bone at the back of the upper jaw shrinks rapidly. Sometimes the bone can be as thin as 1 -2 mm. Some form of bone grafting must be done in order to place dental implants in the upper jaw. External Sinus Lift Bone Grafting is usually done to augment such thin jaw bone.
Under local anaesthetic , a small bony window is open at the side of the back upper jaw. The sinus membrane is carefully lifted without tearing.
Bone grafting materials are then placed into the sinus. This may come in the form of autogenous bone (patient’s own bone) or Xenograft (bone from another species) or Alloplast (synthetic bone). Recently, long term studies have shown Xenograft and alloplast to be as good as autogenous bone. The advantage of not using autogenous bone is that there is no need for a 2nd surgical site for bone harvest. Therefore, this simplifies the procedure.
The dental implant is then inserted into the grafted sinus. Key points to note for a successful sinus bone graft:
1. Sinus membrane must be intact during surgery
2. No pre-existing sinus infection and pathology
3. Good primary closure with no open wounds
4. Heavy smokers have a lower success rate
Cone beam CT Scan shows formation of bone after 8 months. In this case , Xenograft ( Bio Oss ) was used. No autogenous bone was used and no second surgical site for bone harvesting was required.
External Sinus Lift Bone Grafting
OPG xray shows bone formation in the back of the upper jaw following external sinus lift bone grafting. 5 dental implants were then successfully placed in the grafted bone.
FAQ on external sinus lift bone grafting
When you lose your upper molars , the sinus will expand and increase in size . As a result, there is insufficient bone height for dental implant placement. In our clinic, external sinus lift bone grafting for dental implants is done when the bone height is less than 4 mm.
Sinus lift bone graft is a minor surgery that can be done under local anesthesia in the clinic. You can go home the same day as there is no need for any hospital stay. For patients who are more anxious about the procedure, the surgery can be done under sedation in the clinic.
The sinus lift bone grafting usually takes 1 -2 hours depending on the complexity of the case.
There is no pain during the procedure . Immediate post op, there will be some mild discomfort with some swelling which will subside after a few days.
External sinus lift was first done by Boyne in the 1960s. Many long tern studies have shown long term predictability for dental implant placement. With advances in surgical techniques and dental implant design, the long term success rate is more than 90 percent.
1) Presents of sinus infection and pathology
2) Poor oral hygiene
3) Untreated gum diseases in the adjacent teeth
4) Dr y mouth
5) Severe habit of grinding teeth
6) Chronic liver, kidney diseases
7) Uncontrolled diabetes.
8) Uncontrolled hypertension
9) Undergoing chemotherapy or radiotherapy for treatment of malignant tumours.
1) Complete your course of antibiotics as prescribed.
2) Ice pack for two days to reduce swelling
3) Soft diet for a few days following your surgery eg porridge , noodle soup , soy milk , yogurt etc 4) Avoid violent sneezing
and blowing of nose for two weeks
5) Rest at home and avoid strenuous exercise.
6) If you are a smoker, avoid smoking or reduce smoking for as long as possible.
7) Good oral hygiene is important. Rinse your mouth with chlorhexidine mouth rinse 2-3 times a day.