Sinus Lift

A sinus lift is a bone-grafting procedure carried out when there is not enough bone height in the back of the upper jaw to hold an implant. Just above the upper back teeth, inside the upper jawbone and beneath the cheekbone, there is an air-filled space: the maxillary sinus. The thin membrane lining its floor (the Schneiderian membrane) is gently lifted, bone graft material is placed in the space this creates, and the height of bone available to anchor the implant increases.

It is not an operation on your nose or on the sinus itself; only the floor of the sinus is raised by a few millimetres. It has one purpose: to make it possible to place a dental implant in that area.

Why does bone in the upper back jaw get so thin?

Two things happen at the same time. First, once a tooth has been extracted, the bone that held it no longer carries any load, so it gradually resorbs and loses height from below. Second, the sinus expands into the space the teeth have left, so it also drops from above. In an area that has been without teeth for years, only a few millimetres of bone may remain between the sinus floor and the mouth. Add the fact that upper-jaw bone is more porous and softer than lower-jaw bone, and a firm hold for an implant becomes difficult.

A standard-length implant generally needs around 8–10 millimetres of bone height. That measurement is taken from a three-dimensional CBCT scan, not a panoramic X-ray, because the sinus floor is not flat: it can have internal walls and recesses.

Open or closed sinus lift: what decides the technique?

The choice depends largely on how much bone height remains. As a rough guide, if around 5 millimetres or more remains, the closed technique is often enough; if less, the open technique comes into consideration. This is not a hard cut-off — bone quality and the shape of the sinus floor are taken into account as well.

In the closed technique, the implant site is prepared and the thin bone of the sinus floor is gently pushed upwards with special instruments, lifting the membrane with it. In the open technique, the gum is folded back, a small window is made in the side wall of the sinus, the membrane is lifted under direct vision and the space beneath it is filled with graft material.

Implant on the same day, or months later?

If the remaining bone is enough to hold the implant firmly from day one, the implant is placed at the same appointment as the sinus lift, which saves you one surgical visit. If the remaining bone is too thin for that, the graft goes in first on its own, and the implant is placed at a second appointment once the bone has matured. The CBCT scan usually tells us which applies; sometimes the final decision is made during the procedure, once we can see the quality of the bone. We discuss this possibility with you beforehand so that there are no surprises in the chair.

Graft material options, and how lost bone is rebuilt in general, are explained in detail on our dental bone grafting page.

How long does healing take after a sinus lift?

The graft takes time to turn into your own bone. As a general guide, after 4–6 months with the closed technique and 6–9 months with the open technique, either the permanent tooth is made on the implant or, in a staged plan, the implant is placed. This period cannot be shortened; rushed healing puts the implant's hold at risk. In the first few days you may have swelling in the cheek, sometimes bruising that spreads below the eye, and a slightly blood-stained discharge from the nose; these usually settle within a week.

Why can't I blow my nose after a sinus lift?

The lifted membrane is fragile for the first few weeks. Blowing your nose, sneezing with your mouth closed or drinking through a straw all create pressure inside the sinus; that pressure can tear the membrane and shift the graft. For the first two weeks, the rules are:

• Do not blow your nose; just wipe away any discharge.
• Keep your mouth open when you sneeze.
• Do not use straws, and do not smoke.
• Flying: the standard advice is not to fly for at least two weeks, as pressure changes in the cabin can strain the healing sinus membrane. After a small closed-technique lift your dentist may clear you sooner. If you are travelling for treatment, book your return flight with this in mind.
• Diving needs a longer wait, and strenuous exercise should be avoided for the first week. Wait for your dentist's go-ahead for both.
• Do not chew on the operated side; if you wear a removable denture, do not put it in over that area until we have adjusted it.

Take the prescribed medicines — usually an antibiotic, a painkiller and a decongestant nasal spray — for the full course. Swelling that gets worse after the third day, a fever, foul-smelling or thick discharge from the nose, or sand-like granules coming out of your nose are not part of normal healing: contact us without delay, and if you are not in İzmir, see the nearest dentist. If swelling spreads rapidly across your face, or you have a high fever or difficulty swallowing, go to the nearest emergency department.

Is a sinus lift always necessary?

No. Where only a few millimetres of bone are missing, short implants can be enough in some cases without touching the sinus at all. In patients who have lost all their upper teeth, the back implants can be placed at an angle so that they pass in front of the sinus; that is the logic behind All-on-4 planning. If you have untreated sinusitis, an ear, nose and throat (ENT) assessment is needed first; we do not plan this procedure until the sinus is healthy. For people who do not want implants, a bridge or a partial denture is still a valid option.

At our clinic in İzmir, planning starts with a CBCT scan: we look at the bone height, the shape of the sinus floor and the condition of the membrane together, and discuss which route suits you. The cost depends on the technique, the amount of graft material and the number of implants; you receive a written, itemised quote after the examination. If you are travelling for treatment, our post on flying to İzmir for dental work covers flying after dental surgery.