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Sinus lift

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X-ray showing a sinus lift in the left upper jaw
Sinus lift surgery, 3D illustration

Maxillary sinus floor augmentation[1] (also known as a sinus lift, sinus graft, or sinus augmentation) is a surgical procedure that increases the amount of bone in the posterior maxilla by lifting the Schneiderian membrane and placing a bone graft.[2]

After upper jaw tooth loss, the bone may shrink and the sinus cavity can expand into the space. Sinus augmentation restores bone volume, creating a stable foundation for dental implant placement.[3]

Indications

The main indication is to provide sufficient bone under the maxillary sinus for implants.[4]

Sinus pneumatization and bone resorption can follow long-term tooth loss, periodontal disease, or trauma.[5]

Candidates include:

  • Loss of one or more posterior maxillary teeth
  • Severe bone loss in the posterior maxilla
  • Congenital absence of teeth
  • Fully edentulous maxilla needing implants

Cochrane reviews report no clear evidence that sinus lifts are more effective than short implants in reducing implant failure.[6]

Technique

Stages of a lateral window sinus lift procedure

Assessment is made with panoramic radiographs or cone beam computed tomography to evaluate sinus anatomy and rule out pathology.[7]

Lateral window technique

The lateral (traditional) approach creates a window in the sinus wall, lifts the membrane, and places graft material. Healing usually takes 4–12 months.[8]

Bone substitutes include autograft, allograft, xenograft, and alloplast.[9] Long-term success exceeds 90%.[10]

Osteotome technique

The osteotome method, developed by Hilt Tatum and later described by Robert B. Summers,[11] uses a transcrestal approach with osteotomes. It is less invasive but limited in augmentation. Implant survival remains high.[12]

Variations include the Localized Management of Sinus Floor (LMSF) technique[13] and use of electrical mallets to simplify transcrestal elevation.[14]

Complications

Reported complications include:

  • Schneiderian membrane perforation
  • Sinusitis[15]
  • Infection[6]
  • Inflammation[16]
  • Pain, bleeding, or graft failure

Recovery

Bone healing generally requires 3–6 months, though implants can sometimes be placed simultaneously.[17]

History

The sinus lift was pioneered by Hilt Tatum in 1974 (Opelika, Alabama). Philip Boyne and R. A. James published the first reports in 1980.[18]

Cost-effectiveness

The transalveolar method is less costly and invasive, while the lateral window is more effective in severe cases.[19]

References

  1. ^ Boyne, Philip J.; Lilly, Leslie C.; Marx, Robert E.; Moy, Peter K.; Nevins, Myron; Spagnoli, Daniel B.; Triplett, R. Gilbert (2005). "De Novo Bone Induction by Recombinant Human Bone Morphogenetic Protein-2 (RHBMP-2) in Maxillary Sinus Floor Augmentation". Journal of Oral and Maxillofacial Surgery. 63 (12): 1693–1707. doi:10.1016/j.joms.2005.08.018. PMID 16297689.
  2. ^ "Sinus Lift Surgery – Sinus Augmentation". Colgate. Archived from the original on 2015-07-01.
  3. ^ "Sinus lift procedures". Cambridge University Hospitals. Retrieved 2025-09-26.
  4. ^ "Sinus lift procedures". Cambridge University Hospitals. Retrieved 2025-09-26.
  5. ^ Wagner, F; Dvorak, G; Nemec, S; Pietschmann, P; Figl, M; Seemann, R (2017). "A principal components analysis: how pneumatization and edentulism contribute to maxillary atrophy". Oral Diseases. 23 (1): 55–61. doi:10.1111/odi.12571. PMID 27537271.
  6. ^ a b Esposito, Marco; Felice, Pietro; Worthington, Helen V. (2014). "Interventions for replacing missing teeth: augmentation procedures of the maxillary sinus". Cochrane Database of Systematic Reviews (5) CD008397. doi:10.1002/14651858.CD008397.pub2. PMC 10821778. PMID 24825543.
  7. ^ Baciut, Mihaela; Hedesiu, Mihaela; Bran, Simion; Jacobs, Reinhilde; Nackaerts, Olivia; Baciut, Grigore (2013). "Pre- and postoperative assessment of sinus grafting procedures using cone-beam CT compared with panoramic radiographs". Clinical Oral Implants Research. 24 (5): 512–516. doi:10.1111/j.1600-0501.2011.02408.x. PMID 22220751.
  8. ^ "Sinus Lift Surgery". Perio.org. Retrieved 2025-09-26.
  9. ^ Kumar, Prasanna; Vinitha, Belliappa; Fathima, Ghousia (2013). "Bone grafts in dentistry". Journal of Pharmacy & Bioallied Sciences. 5 (Suppl 1): S125 – S127. doi:10.4103/0975-7406.113312. PMC 3722694. PMID 23946565.
  10. ^ Riben C, Thor A (2016). "Maxillary Sinus Implants without the Use of Graft Material". Clinical Implant Dentistry and Related Research. 18 (5): 895–905. doi:10.1111/cid.12360. PMID 26482214.
  11. ^ Summers, Robert B. (1998). "Sinus Floor Elevation with Osteotomes". Journal of Esthetic and Restorative Dentistry. 10 (3): 164–171. doi:10.1111/j.1708-8240.1998.tb00352.x. PMID 9759033.
  12. ^ Alshamrani, Abdulrahman M; Mubarki, Mazen; Alsager, Abdulelah S; Alsharif, Hussam K; AlHumaidan, Saud A; Al-Omar, Ahmad (2023). "Maxillary Sinus Lift Procedures: An Overview of Current Techniques, Presurgical Evaluation, and Complications". Cureus. 15 (11) e49553. doi:10.7759/cureus.49553. PMC 10753870. PMID 38156177.
  13. ^ Bruschi, G. B.; Scipioni, A. (1998). "Localized management of sinus floor with simultaneous implant placement: a clinical report". Int J Oral Maxillofac Implants. 13 (2): 219–226. PMID 9581408.
  14. ^ Crespi, Roberto; Capparè, Paolo; Gherlone, Enrico Felice (2013). "Electrical mallet provides advantages in split-crest and immediate implant placement". Oral and Maxillofacial Surgery. 18 (1): 59–64. doi:10.1007/s10006-013-0389-2. PMID 23329162.
  15. ^ Felisati G; Chiapasco M; Lozza P (2013). "Sinonasal complications resulting from dental treatment: outcome-oriented classification and protocol". Am J Rhinol Allergy. 27 (4): e101–6. doi:10.2500/ajra.2013.27.3936. PMID 23883801.
  16. ^ Fischer, Jakob L.; Riley, Charles A.; Kacker, Ashutosh (2023). "Sinonasal Complications Following the Sinus Lift Procedure". Ochsner Journal. 23 (2): 147–151. doi:10.31486/toj.22.0125. PMC 10262945. PMID 37323513.
  17. ^ Riben, C.; Thor, A. (2012). "Maxillary Sinus Implants without the Use of Graft Material". International Journal of Dentistry. 2012 105483. doi:10.1155/2012/105483. PMC 3383004. PMID 22754569.
  18. ^ Boyne, P. J.; James, R. A. (1980). "Grafting of the maxillary sinus floor with autogenous marrow and bone". J Oral Surg. 38 (8): 613–616. PMID 6993637.
  19. ^ Listl S, Faggion CM (2010). "An economic evaluation of different sinus lift techniques". J Clin Periodontol. 37 (8): 777–87. doi:10.1111/j.1600-051X.2010.01577.x. PMID 20546083.

Notes

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