Bone augmentation in the upper jaw
Many patients are afraid of sinus lift surgery. This is unjustified, however, because it is one of the safest methods for bone augmentation in the posterior region of the upper jaw when performed by an expert. The so-called sinus floor is a thin, bony plate that separates the maxillary sinus from the oral cavity. The posterior teeth are located in this bone.
The loss of one or more teeth causes the bone to resorb and the maxillary sinus to enlarge, indicating that there no longer is sufficient residual bone height left for an implant. In order to insert such an implant, the bone must be augmented first by way of attaching bone graft material between the maxillary sinus floor and the maxillary sinus mucosa. The inserted material serves as a placeholder as the bone gradually becomes denser over time.
Depending on the amount of bone material needed, two different sinus lift techniques can be used: the indirect, minimally invasive technique and the direct technique. The aim of both procedures is to lift the maxillary sinus floor in conjunction with bone augmentation, whereby the indirect technique should only be used if sufficient residual bone height is present.
Indirect sinus lift / minimally invasive
If the patient's anatomical conditions allow it, the indirect sinus lift can be used. This procedure is less unpleasant for the patient because the postoperative discomfort is not as severe.
With the indirect sinus lift, a hole is drilled into the upper jaw where the tooth was previously located. Drilling is carried out just until the transition to the maxillary sinus.
The last millimeter is removed with an ultrasonic diamond. Afterwards, the maxillary sinus floor mucosa is lifted from the inside using water pressure technology. The ultrasound technique is very gentle on the mucous membrane because it is minimally invasive, i.e., no large incision is needed. Pain and swelling usually do not occur. The newly created cavity between the bone and the mucous membrane is filled with bone material that has osteoconductive properties. If possible, the implants are placed immediately.
Direct sinus lift
In this technique, the maxillary sinus is opened through a small “window” on the outside of the sinus wall, which is accessed via the maxillary mucous membrane and the bone. After making this small opening, the sinus floor mucosa is lifted and the resulting cavity filled with bone material and, if necessary, a membrane.
The "window" that was opened in the bone is now closed with a membrane to facilitate bone formation. The membrane is absorbable, i.e., it is completely absorbed by the body. In the next months to years, this material is degraded and replaced by new bone.