When teeth are missing in the upper posterior (back) you may be required to have a sinus lift or a sinus graft in order to do your implants. Our cheek bones are hollow. This hollow space is called the maxillary sinus. That is why when you get a head cold you feel pressure in your eyes and in your cheeks. If your sinus is large or very large then you may have insufficient bone height for placement of your implants. Use of a sinus lift or sinus graft are ways we can re-grow bone in the sinus.
If there is sufficient bone height (4-6mm) to get primary stability of the implant then the sinus lift/graft can be done at the same time as the implant placement. If there is not sufficient bone (4mm) to get primary stability of the implant, then the sinus lift/graft has to be done. Allow the graft to heal for 8 months and then return for placement of your implants.
A sinus lift is done when only minor vertical bone augmentation is needed. The implant preparation (hole) is made right to the floor of the sinus without going in. Then bone graft material is placed into the hole and using some “gentle tapping” the floor of the sinus is bumped up, or lifted, tapping the bone graft into the sinus. The implant is placed, and the newly grafted bone in the sinus will transform into natural bone.
A sinus graft is done when major vertical bone augmentation is needed, or when more than one implant will be placed into the sinus. For this approach a window, similar to a trap-door or a doggy-door, is made into the side of the sinus. The sinus is then grafted with bone graft material to be transformed into new bone. If primary stability of the implant can be insured the implants can be placed at the same time as the sinus graft. If primary stability is not possible the graft will need to heal for 8 months prior to implant placement.