Dental implants are naturally looking artificial tooth which replaces the missing tooth and are place beneath the gums into the jaw. It serves as an anchor and supports the crown or dentures.
Dental implant is the best option for tooth replacement with around 90% success rate. It improves self confidence, esthetics, masticatory function and overall oral health.
However, bone loss or reduce bone height at the implant site plays one of the major drawback in implant placement. Believe it or not, bones need stimulation to maintain its form and density.
Bone Loss and Consequences
In case of alveolar bone, the teeth do the function due to its numerous contacts with each other throughout the day. Hence, help the alveolar bone in continuous remodeling and rebuilding.
Bone loss occurs when there is lack of stimulation by the tooth in the alveolar bone. With time, without the teeth, bone width and height decreases and the face collapse as the tongue spreads into the space causing facial sagging. It may also impaired normal functions like chewing and speaking.
Without proper bone thickness and height, implant cannot be placed as it needs bone for support but with recent advances in implantology, some of the bone can be regenerated by the placement of bone grafts at the implant site and serve as a scaffold for new bone formation.
Sinus Lift
Sinus lift is a bone grafting procedure done in the upper jaw in premolars and molars region (the area of face where maxillary sinus is present) when the bone volume is inadequate for implant placement.
During sinus lift procedure a portion of the sinus is filled with bone graft so that enough bone volume is present for the placement of the implant. The bone graft is place between the sinus floor and the sinus membrane. It can be done at the same time with implant surgery or 6 months before implant placement.
Considerations
The healing time for bone grafting is around 6 months (4-8 months) and 3-6months for implant healing.
In case, if the original bone thickness is more than 4-5mm, sinus lift with immediate implant placement can be done but if the thickness is less than 4-5mm then two stage surgeries can be done.
Type of Bone Grafts
The following bone grafts can be used –
Autograft, though difficult to obtain it is still considered the gold standard bone graft material.
Allograft or Xenograft from prepared bones like frozen bone, demineralized freeze-dried bone, etc.
Alloplastic materials like hydroxyapatite, etc.
Success Rate
According to a study by Yoon 2014, the survival rate for implant placement with sinus lift technique varies from 92 to 97%.
Host related factors like poor oral hygiene, smoking, etc plays an important role in implant failure with sinus lift technique and may results in a lack of stability of immediate implants. However, such host related failure can be applicable for all implants regardless of the technique used.
Type of bone grafts used and its resistance to sinus pneumatization is another factor associated with implant failure with sinus lift technique.
Conclusion
The Sinus lift procedure is done as a routine daily procedure under local anesthesia. Recent advances and innovations in medicines make the technique a pain free procedure. Post operatively to manage the discomfort like pain and sinus swelling drugs like ibuprofen and nasal decongestant can be prescribed.
