Sinus augmentation is a surgical procedure performed in by the dentist to reposition or lift the sinus to a position that is most appropriate. The maxillary sinus is approximately located along the area of the roots of the upper first molars. While it is normally positioned above, in an area high enough so as not to be pierced by the roots of the tooth, or any foreign material, such as an implant, that may impinge the sinus. During a tooth extraction, the low position of the maxillary sinus also puts the patient at risk because of accidental fractures of the root or breakage of the instruments.
When a radiograph suggests that the sinus is set too low, thus disrupting or prohibiting the performance of a particular procedure, a sinus augmentation is prescribed. Also known as a sinus lift or a sinus graft, the sinus is lifted a few millimetres above its original position and some bone graft is added beneath it, to reinforce and support its new position.
Indications for a Sinus Augmentation
A sinus augmentation may be prescribed for the following cases:
- Bone maybe lost because of many reasons. Periodontal disease is an example of a severe condition that can lead to extreme bone loss and when this occurs at the area of the maxillary molars, the sinus may be compromised.
- When a patient is about to receive an implant on the area of the upper first molars, but the procedure cannot be performed because the sinus is set too low. The shape of the maxillary sinus is different for every person. When the shape of the sinus encroaches greatly on the healthy bone or if very little bone is left in its boundary, a sinus lift is indicated.
- Bone resorption is a natural phenomenon that can be expected after a tooth extraction. When a recent tooth extraction has resulted to great bone loss that prohibits implantation on that area, sinus grafting or sinus lifting becomes necessary.
- Long-time edentulism can be quite unfortunate sometimes. This is especially true when the patient has worn removable dentures for a long time. Long-time denture wearing subjects the bone to much force that causes bone resorption. Often when this is the case the sinus will appear to be set too low so that a lift is going to be required.
When a sinus augmentation procedure is required, a few things will be prepared. Radiographs and CT scans will be taken to approximate the position of the sinus and bone grafts will have to be obtained. Nowadays, bone may be harvested either from a human body or it may be synthetically produced.
To perform it, the gum will be incised to expose the bone, and a small hole is made to be able to access the sinus by a handy instrument. Through that small window, the sinus is carefully handled so that it may be lifted to an appropriate position. This is a delicate membrane that should be manipulated with great care, so as not to impinge or damage it. Once repositioned, granules of the bone graft is deposited into the area to stabilize the sinus in its new position. As soon as the bone is added, the incised tissue is replaced and then sutured. Scheduled follow-ups will be in order after the procedure, to ensure proper tissue healing and success.