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Sinus Floor Augmentation – Sinus Lift Explained

Sinus floor augmentation is a surgical procedure to build up bone in the upper jaw, enabling the safe placement of dental implants in the posterior maxilla.

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Things worth knowing about "Sinus floor augmentation"

Sinus floor augmentation is a surgical procedure to build up bone in the upper jaw, enabling the safe placement of dental implants in the posterior maxilla.

What is sinus floor augmentation?

Sinus floor augmentation – also known as a sinus lift or sinus floor elevation – is an oral surgical procedure in which bone is added to the posterior upper jaw, directly beneath the maxillary sinus. The goal is to create sufficient bone volume to allow stable placement of dental implants.

In the upper molar and premolar region, available bone height is often inadequate following tooth loss, as the jawbone resorbs over time while the sinus cavity simultaneously expands downward. Sinus floor augmentation compensates for this lost bone volume using suitable bone grafting materials.

When is sinus floor augmentation necessary?

The procedure is indicated when:

the residual bone height in the posterior upper jaw is below approximately 4–8 mm,
significant bone resorption (bone atrophy) has occurred following tooth loss,
the maxillary sinus has expanded excessively downward (sinus pneumatization),
dental implants are planned in the posterior maxilla.

Techniques for sinus floor augmentation

Lateral window approach (open sinus lift)

In the lateral sinus lift, a small window is created in the lateral wall of the maxillary sinus. The sinus membrane (Schneiderian membrane) is carefully elevated and the resulting space is filled with bone graft or bone substitute material. This technique is suitable when the residual bone height is less than 4 mm.

Transalveolar approach (closed sinus lift)

In the transalveolar sinus lift, access is gained through the future implant site using specialized instruments that gently push the sinus floor upward before the grafting material is introduced. This minimally invasive technique is used when at least 4–5 mm of bone height is available.

Materials used

Various materials can be used for augmentation:

Autologous bone (the patient's own bone, e.g., from the chin or iliac crest) – considered the gold standard
Allogeneic bone (processed and sterilized bone from human donors)
Xenogeneic bone (bovine-derived, e.g., Bio-Oss®)
Alloplastic materials (synthetic bone substitutes, e.g., hydroxyapatite-based)

Procedure overview

The procedure is typically performed on an outpatient basis under local anesthesia. Sedation or general anesthesia may be offered in some cases. After the grafting material is placed, the wound is carefully sutured. Depending on the technique and material used, the healing period before implant placement ranges from 4 to 9 months.

Risks and complications

As with any surgical procedure, certain risks exist:

Perforation of the Schneiderian membrane
Infection or sinusitis (sinus infection)
Swelling and bruising at the surgical site
Graft failure or incomplete integration
Bleeding

Serious complications are rare when the procedure is performed by an experienced oral and maxillofacial surgeon.

Aftercare and healing

Careful postoperative care is important for successful healing:

Taking prescribed antibiotics and anti-inflammatory medications
Avoiding forceful nose blowing and sneezing during the initial healing period
Eating soft foods in the operated area
Attending regular follow-up appointments with the surgeon or dentist
Avoiding smoking, as it significantly impairs healing

Success rates

Sinus floor augmentation is considered a well-established and predictable procedure with high success rates. Studies report implant survival rates of over 90% after 5 years. Outcomes depend significantly on the quality of the grafting material, surgical technique, and the general health of the patient.

References

Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? International Journal of Oral and Maxillofacial Implants, 2007;22 Suppl:49-70.
Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Journal of Clinical Periodontology, 2008;35(8 Suppl):216-240.
Del Fabbro M, Testori T, Francetti L, Weinstein R. Systematic review of survival rates for implants placed in the grafted maxillary sinus. International Journal of Periodontics and Restorative Dentistry, 2004;24(6):565-577.

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