When a patient intends to replace a missing or failing tooth, the dentist must ensure that there is bone in the jaw is capable of anchoring the implant, regardless of its position.
However, when dealing with an upper back tooth, and there is not enough bone under the gum, the base of the implant might eventually poke through an area that is referred to as the Sinus Cavity. As it is impossible to anchor a dental implant to air; thus, this presents a minor problem, and requires a small in-office surgical procedure called a Sinus Membrane Lift.
A sinus membrane lift (also known as Sinus Augmentation), is a procedure that involves the involvement of addition bone to help fill in the air space, in order to raise the floor of the sinus cavity. Several variables account for why patients do not have bones to support implants; some of such variables are the size and shape of the sinus cavities.
In some cases, the bone has been lost from the area. There are many reasons for this loss. Thus, usually occurs when teeth are lost and the bone suffers stimulation, which signals the body to stop producing new bone cells in that region. This will result in the decrease of volume and density of the bone. Again, where the patient’s tooth loss was due to periodontal (gum) disease, the tooth that holds the bone might decrease as a result of the disease.
One might wonder where the bone used in the lift will derive from. It may be obtained from some other part of the patient’s body, such as another part of the jaw or the hip. But usually, bone-grafting materials are processed in a laboratory, especially for this procedure. The original source may be a human or animal donor, usually a cow (synthetic products may be used as well). The contents are specially treated and carefully sterilized. Bone grafts act as scaffolds that are eventually replaced by the body.
Before the procedure is carried out or even scheduled, certain information has to be finalized, such as the shape, location, and health of the sinus using x-ray imaging. The sedative of choice is also discussed between the doctor and patient. The surgery is conducted under local anesthesia by numbing the area. Although some people require additional sedation or anti-anxiety medication, which is usually administered by mouth or through the vein via injection.
The procedure involves the numbing of the area to be operated on, and an incision is then made in the gum to expose the bone that once contained the missing tooth or teeth. The membrane that lines the sinus is later revealed via a small incision. The layer is to be raised, and space beneath it filled with the bone graft materials. The gum is thereafter stitched back up. Sometimes the implant(s) may be placed directly into the grafting material before the glue is closed, to eliminate the need for a second surgical procedure intended to place the implant. However, most dentists prefer performing two surgeries, as this allows the surgical site to properly heal. Doctors that prefer this route will recommend that patients wait approximately 6-7 months before an implant is placed.
What to Expect After Sinus Surgery
After the process, you may experience certain post-surgical discomforts such as moderate swelling and aches that persists for a few days — about the same as having an upper impacted wisdom tooth removed. Depending on the circumstances of each case, non-steroidal anti-inflammatory medication (prescription or over-the-counter) may be recommended to help minimize discomfort – antibiotics may be prescribed to prevent infection. In the event that the sinus membrane becomes a bit inflamed, leading to a feeling of minor congestion, a decongestant can prove helpful.