Hello friends. Today I will talk about sinus lifting, which is one of the bone augmentation methods during or before implant placement. First of all, what is this sinus, where is it located, which of our teeth does it affect, and in which area do we need this when placing implants?
The sinus is an air space. They are the air spaces located on both sides of our nose, above our maxilla, our upper jaw. What do these air spaces do? These air spaces balance the weight of our head, they warm the breath we take. They have many functions like this. These air spaces are related to the nose, to the conchae in our nose, and generally to our back teeth. That is why, generally when we are going to place an implant in the back region, the boundary of the lower floor of the sinus is a guide for us. Sometimes this sinus floor has come down all the way. This situation generally shows genetic transmission, but we also observe it in our patients who lost teeth at an early age.
What harm does this do us? When an implant is to be placed in the back region, if the sinus floor has come down all the way, because that air space has come down so low, we may not have enough bone there for the implant. In such cases we first go for bone augmentation. That is, we raise bone in the jawbone and place the implant either in the same session or in later sessions.
We generally perform this sinus lifting method in 2 ways. This depends on the height of the bone. If our patient has about 4-5 millimeters, that is, about 5 millimeters of bone, we do a sinus lift with the closed technique and place our implant in the same session. We can do this during the procedure with special drills and osteotomes. After the implant socket is opened in the sinus region, after drilling, we lift the sinus floor membrane with special instruments and place our implant. This gives us convenience during the procedure. We lift the sinus membrane and, where we see fit, put bone powder in between and place the implant. Sometimes we place the implant without putting bone powder. The advantage of this is that during the procedure there is both patient comfort, and we can place the implant in the same session. But with this technique we can only achieve a very small amount of bone augmentation. We generally apply this method when we need 1-2 millimeters of bone height, that is, when we need 2 more millimeters above 5 millimeters.
If there is severe bone loss in our patient, that is, if there is bone loss of 4 millimeters or less, then we apply the open sinus method. How do we do this? We do it by opening a small window on the buccal side of the face, the jawbone, in the lateral area, lifting the membrane in that area with special instruments, putting bone powders in between, closing the window again. Depending on the amount and width of the remaining bone, sometimes we can place the implant in the same session and wait about 4-6 months. Sometimes we find it appropriate to wait about 4-6 months and then place the implant.
Which materials do we use for the gain? There are various methods, but in my own clinic I generally use large-particle bone powders, bone grafts. Sometimes, if I can find it, I also take a little of the patient's own bone, mix it in and apply it. And I take the patient's own blood, make a nice protective membrane on top of it and close it that way.
After the patient has had these surgical procedures, what should they pay attention to? They should not make hard nose movements. Because, as I said at the beginning, since the sinus is related to the nose and the mouth, they should avoid situations that could create pressure inside the mouth, they should not blow their nose, they should not use a straw. When they have a sneeze, if possible they should sneeze with their mouth open, and cough the same way. They need to pay a little attention to this, and once the bone has matured it is a completely risk-free situation.
Periodontology Specialist Dt. Nergiz Hamamcı
Özel Klinik 99 Oral and Dental Health Polyclinic
0540 640 6006
Güvenlik Cd. No:99 A-B