Implant treatmentis the best solution for replacing missing teeth. Unfortunately, in order to have an implant fitted, the patient’s alveolar process needs to be of an appropriate width and height. One of the limitations for the implantation procedure in the lateral maxilla is that the sinus is often lowered.
This is due to the fact that with every year following the extraction of lateral teeth, the lateral bone height gradually decreases. The process is very slow, but continuous. When vertical bone height falls below 8~10 mm the sinus lift procedure becomes necessary. The procedure allows for the fitting of implants through reducing sinus volume,while increasing bone base necessary for the placement of dental implants.
There are two sinus lift techniques:
- open method– applied in a situation where the thickness of the existing bone is less than 6-7 mm. The procedure starts with drilling a window in the lateral sinus wall. For opening the sinus, a piezoelectric bone cutting instrument is used, which ensures great precision of the procedure, as well as its atraumatic character (see -> Piezosurgery). After the mucous membrane is lifted, a bone substitute material is placed in the space obtained at the bottom of the sinus. The bone window is closed with a barrier membrane, covered with the patient’s mucous membrane (gum) and stitched tightly (see -> bone regeneration with biomaterials). Depending on the indications, the implant fitting procedure is carried out during the same appointment or after a period necessary for the formation of a new bone tissue.
- closed method – applied where the thickness of the existing bone exceeds 6-7 mm. The placing of the substitute bone material is carried out through a whole drilled for the purpose of fitting an implant. The sinus mucous membrane is elevated using special instruments – osteotomes – in order to create free space between the mucous membrane and the alveolar bone. Then the biomaterial is placed in this space and the implant is fitted during the same appointment. The disadvantage of this method is a limited scope of bone reconstruction, the necessity to repeat the same procedure with every implant that is fitted, lack of visual control over the surgical site, which significantly increases the risk of sinus mucous membrane perforation.
THE PURPOSE OF SINUS LIFT IS TO RESTORE THE CHEWING FUNCTION AND TO IMPROVE THE PATIENT’S APPEARANCE, regardless of the causes and extent of alveolar degeneration in the lateral maxilla.