A sinus lift is a special surgical method in which the bony floor of the maxillary sinus (lat. Sinus maxillaris) is thickened by the introduction of suitable bone substitute. Without this surgical technique, many of the necessary maxillary implant surgery could not be reliably performed. Because in many cases, the thickness of the bone layer in the antrum is not sufficient to fully absorb the cylindrical implant. By means of a sinus lift, sinus lift cost so huge, however, a sufficient bone height can be achieved, so that the implant can heal firmly enough substance.
Various procedures for the sinus lift
Basically, a sinus lift can be realized with three different methods:
External sinus lift
With the external or direct sinus lift, the access takes place in the lateral (lateral) area. This method is used when the bone substance is already reduced to such an extent that an internal sinus lift is no longer an option. This is usually the case when missing teeth have not been replaced immediately after removal, but for several years at this point was a gap. Then not only the opposing teeth of the important masticatory pressure is missing so that they can be damaged in the long term, but also the bone substance degrades slowly and continuously for lack of load.
For the external sinus lift, it may be necessary to wait and see how the bone development develops. Only when sufficient stability in the antrum is reached again, the actual implant can be used. This prolongs the healing time and, in this case, the patient has to undergo several orthodontic treatments.
Internal sinus lift
In an internal or indirect sinus lift, the jawbone is drilled to just below the bony floor and the sinus mucosa is carefully separated from the bone by the resulting hole. In the resulting cavity then the self-bone material is filled, resulting from the opening of the jaw, often mixed with bone substitute material. Access and jawbone structure is made via the implant bore. In the new, thickened bone layer, the implant is then used to heal there. It takes several months for the bone structure to complete and for the sinus lift to stabilize sufficiently to be treated with dentures.
The balloon procedure is a variant of the internal sinus lift that provides access to the maxillary sinus through the implant hole. Through this hole, a small balloon is introduced and slowly inflated. As a result, the balloon expands and lifts the maxillary sinus mucosa from the bone. Thereafter, the balloon is removed again, and the resulting cavity can be filled with bone material.
Course Of Treatment: First Bone Augmentation, Then Implant
In order for the implant to find a secure hold in the jawbone of the upper jaw, a sinus lift must first be performed in order to increase the bone level that is too low. Bone material is then filled into the resulting cavity before the actual implant is inserted into the bone and can heal. Sinus lift and bone augmentation can either be done in advance in a separate session or during implantation.
The First Few Weeks After A Sinus Lift Operation Are Particularly Important
Pain is not uncommon after such a procedure. Therefore, patients should not be afraid to take an effective painkiller after surgery. At least for a period of two weeks, any pressure on the maxillary sinus must be avoided at all costs. For this reason, special care should be taken when whining, sneezing or lifting heavy loads. Also on diving trips or air travel, you should completely do without during this time.
Smokers should know that the neurotoxin nicotine has a negative effect on wound healing and thus prolong or even endanger the healing phase. A sinus lift operation is, therefore, a welcome opportunity to give up smoking for good or at least limit it for as long as possible, at least for a few weeks.
Which Bone Materials Can Be Used?
In principle, other substitute materials can be used in addition to self-bone material, which is obtained when opening the jaw and preparing the bone for the implant:
Material Type: Natural autogenous bone material from patient allografted bone material from another human xenografted bone material from another mammal (e.g., bovine) alloplastic synthetic bone material, e.g. B. hydroxyapatite surgery and implantation
The sinus lift today is a routine operation, but like any surgical operation, it can be associated with complications. This can lead to problems when opening the maxillary sinus, as well as when the maxillary sinus membrane is injured. In addition, the operation must be performed under sterile conditions to avoid contamination with germs and consequent inflammation of the antrum.
With an internal sinus lift, the surgeon gains access to the jaw via the drill channel for the implant body to be placed. The drill channel is not placed on the entire length of the implant to avoid injury to the tissue. Once the surgeon reaches the membrane at the floor of the antrum, the bone is manually augmented with a special instrument or balloon and then raised a few millimeters, again over the hole. Subsequently, the bone substitute material is introduced into the cavity and used to close the borehole implant.
For the complete healing of an implant with an internal sinus lift the patient needs a bit of patience – on average up to eight months. Only then can the implant be fitted with a superstructure (crown, bridge, prosthesis) and fully loaded.
In the case of an external sinus lift, access is from the side, so the gum is first opened under local anesthesia and folded back to expose the bone. The surgeon then accesses the membrane in the maxillary sinus through a small hole in the lateral maxillary bone and gently removes it from the floor of the maxillary sinus. Thereafter, the bone substitute material can be introduced as a relining and heal.
An external sinus lift requires a shorter healing time. With a small bone loss in the jaw, the implant can be used directly after the sinus lift. In more severe cases, the body must first form new bone before the implant can be used after about three months.
Sinus lift – Experiences
The sinus lift is a proven surgical method that has been used for decades and has a very high success rate even in long-term studies over 20 or more years. The actual surgery is completely painless for the patient; However, swelling and pain in the jaw are possible especially in the first days after sinus lift. The chewing and speaking function may be limited for a few days, but these symptoms usually resolve within a week.
In order not to endanger the healing, the dentist or implantologist will prescribe rest to the patient in the first days after surgery. The patient should also take prescribed or given tablets (analgesics, analgesics) in accordance with the medical guidelines and also follow the appointments for follow-up examinations.
What Costs Must Be Expected?
The sinus lift cost depends mainly on which surgical method can be used and how much bone must be built. The rental fee for an internal sinus lift is on average between 200 and 300 euros. In addition, there are costs for material, so that the total costs usually move from 300 to 500 euros. For a more complex external sinus lift, patients need to dig deeper into their pockets: here, total costs of 600 to more than 1,000 euros are possible.
Those who have statutory health insurance must finance the costs for the sinus lift (as well as for the implant) themselves. Anyone who has taken out private dental insurance can be reimbursed up to 100% of the treatment and material costs depending on the tariff.