X-ray showing a sinus lift in the left upper jawSinus lift surgery, 3D illustration
Maxillary sinus floor augmentation[1] (also known as a sinus lift, sinus graft, or sinus augmentation) is a surgical procedure that increases the amount of bone in the posterior maxilla by lifting the Schneiderian membrane and placing a bone graft.[2]
After upper jaw tooth loss, the bone may shrink and the sinus cavity can expand into the space. Sinus augmentation restores bone volume, creating a stable foundation for dental implant placement.[3]
Indications
The main indication is to provide sufficient bone under the maxillary sinus for implants.[4]
Sinus pneumatization and bone resorption can follow long-term tooth loss, periodontal disease, or trauma.[5]
Candidates include:
Loss of one or more posterior maxillary teeth
Severe bone loss in the posterior maxilla
Congenital absence of teeth
Fully edentulous maxilla needing implants
Cochrane reviews report no clear evidence that sinus lifts are more effective than short implants in reducing implant failure.[6]
The lateral (traditional) approach creates a window in the sinus wall, lifts the membrane, and places graft material. Healing usually takes 4–12 months.[8]
The osteotome method, developed by Hilt Tatum and later described by Robert B. Summers,[11] uses a transcrestal approach with osteotomes. It is less invasive but limited in augmentation. Implant survival remains high.[12]
Variations include the Localized Management of Sinus Floor (LMSF) technique[13] and use of electrical mallets to simplify transcrestal elevation.[14]
Bone healing generally requires 3–6 months, though implants can sometimes be placed simultaneously.[17]
History
The sinus lift was pioneered by Hilt Tatum in 1974 (Opelika, Alabama). Philip Boyne and R. A. James published the first reports in 1980.[18]
Cost-effectiveness
The transalveolar method is less costly and invasive, while the lateral window is more effective in severe cases.[19]
References
↑ Boyne, Philip J.; Lilly, Leslie C.; Marx, Robert E.; Moy, Peter K.; Nevins, Myron; Spagnoli, Daniel B.; Triplett, R. Gilbert (2005). "De Novo Bone Induction by Recombinant Human Bone Morphogenetic Protein-2 (RHBMP-2) in Maxillary Sinus Floor Augmentation". Journal of Oral and Maxillofacial Surgery. 63 (12): 1693–1707. doi:10.1016/j.joms.2005.08.018. PMID16297689.
↑ Wagner, F; Dvorak, G; Nemec, S; Pietschmann, P; Figl, M; Seemann, R (2017). "A principal components analysis: how pneumatization and edentulism contribute to maxillary atrophy". Oral Diseases. 23 (1): 55–61. doi:10.1111/odi.12571. PMID27537271.
↑ Riben C, Thor A (2016). "Maxillary Sinus Implants without the Use of Graft Material". Clinical Implant Dentistry and Related Research. 18 (5): 895–905. doi:10.1111/cid.12360. PMID26482214.
↑ Bruschi, G. B.; Scipioni, A. (1998). "Localized management of sinus floor with simultaneous implant placement: a clinical report". Int J Oral Maxillofac Implants. 13 (2): 219–226. PMID9581408.
↑ Crespi, Roberto; Capparè, Paolo; Gherlone, Enrico Felice (2013). "Electrical mallet provides advantages in split-crest and immediate implant placement". Oral and Maxillofacial Surgery. 18 (1): 59–64. doi:10.1007/s10006-013-0389-2. PMID23329162.
↑ Felisati G; Chiapasco M; Lozza P (2013). "Sinonasal complications resulting from dental treatment: outcome-oriented classification and protocol". Am J Rhinol Allergy. 27 (4): e101–6. doi:10.2500/ajra.2013.27.3936. PMID23883801.
↑ Boyne, P. J.; James, R. A. (1980). "Grafting of the maxillary sinus floor with autogenous marrow and bone". J Oral Surg. 38 (8): 613–616. PMID6993637.
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