Sinus Augmentation

When people have chosen to have dental implants to restore missing teeth in the upper jaws at the back of the mouth, it is usually necessary to have a three dimensional cone beam CT scan of the region to assess how much remaining bone is present following the careful removal of any unrestorable teeth. If there is insufficient bone height to accept a dental implant the lateral window sinus augmentation technique is the widely accepted best method of care to increase the amount of vertical bone present.

A cut is made in the gum on the affected side and a window is made in the bone allowing access to the thin skin lining the air sinus in the upper jaw. This lining is very carefully peeled off the bone on the inside of the sinus before bone grafting material is placed inside the bony boundaries of the sinus but on the outside of the internal skin lining. A membrane is placed over the window to allow healing and the gum is stitched back over the top using dissolving sutures. Sometimes implants can be placed at the same time. If this is not possible healing relates to the rate of new bone growth in this region and a gap of 9-12 months is required before the next stage of treatment.

Some frequently asked questions:

What is the success rate of this treatment?

Sinus augmentation is successful in over 90% of cases

What are the main side effects?

There are two main complications during treatment which include bleeding and tearing of the sinus lining.

The bleeding is managed during the treatment and you will not be discharged until any bleeding has stopped.

If the sinus lining tears, Paul can repair it during the treatment using a horse collagen-derived biomaterial. He often uses this even if the membrane is not torn, it resorbs away over a period of 4-6 weeks. If the sinus lining tears very badly it may not be possible to carry out the procedure. You would then need to heal for six weeks before trying again.

Post operative pain and swelling which last for up to a week after the procedure. Bruising can last for up to 2 weeks, or a little more if you take medicine to thin your blood.

You are quite likely to have a nose bleed after treatment. Old blood clots will slowly be cleared from your sinus for around two weeks after treatment, this is very normal.

Do implants have good outcomes in these bone grafted sites?

Yes, implants that are placed in augmented sinus sites have a 85% 10year survival rate.

Can this treatment be done in the dental chair?

Yes, we usually suggest that you have some sedation for this treatment but it is more of a personal preference for each person. If you want to have a general anaesthetic or are a little more medically unwell, Paul can treat you at the Duchy Hospital.

What do I need to do to look after the wound after treatment?

You must not smoke for at least 2 weeks before treatment and 2 months after, it is much better for the final outcome and long term success to stop smoking entirely
Please continue to take your antibiotics which start the day before your treatment
You must not blow your nose for three weeks
You must not hold in your sneezes for three weeks
Please use the chlorhexidine mouthwash for two weeks