A sinus lift (also called a maxillary sinus augmentation or sinus floor elevation) is a surgical procedure done to prepare for dental implants. To understand how a sinus lift works, you must know a little about the anatomy of the sinuses.

The sinuses are empty, air-filled spaces in the skull that have several functions, including reducing the weight of the skull. There are four pairs of sinuses. The largest are the maxillary sinuses, located under your eyes and next to each side of the nose. Some of your upper teeth have roots that can extend into the bottom of the maxillary sinuses.

Dental implants require bone to hold them in place. If the bone on the floor of the maxillary sinus is too thin, it may need to be augmented before the placement of dental implants. This is accomplished through a surgical procedure called a sinus lift.

This article will cover who might be eligible for a sinus lift, how a sinus lift is performed, and what to expect before and after surgery.

What Is a Sinus Lift?

A sinus lift involves grafting bone into the floor of the maxillary sinus so dental implants can be attached. This is done when dental implants are needed to replace lost teeth (usually in adults) and the bone in this area has atrophied (become thin or weak) due to periodontal (gum) disease, tooth loss, or other conditions.

A sinus lift is usually performed by an oral surgeon or periodontist on a scheduled outpatient basis with local anesthesia. The bone used in a sinus lift may be:

  • Autogenous: The bone comes from your own body (often removed from other places in your mouth).Allogenic: The bone comes from a cadaver.Xenograft: The bone is from a nonhuman animal, such as a cow (bovine).Synthetic: A bone substitute may be used, often along with bone.

Various Surgery Techniques

A sinus lift may be performed by either open or closed techniques.

Open Sinus Lift

A sinus lift involves going through the mouth and making an incision in the gum line to expose the jawbone. A circle of the bone is cut out and lifted into the sinus cavity. The remaining space is then filled with a bone graft, and the incision is closed.

After about four to 12 months of healing, a dental implant can then be placed in this area. Open sinus lifting is the surgical technique most commonly used.

Most people are suited to open sinus lifts because they can be performed if a person has less than 4 millimeters of residual bone height. Another advantage is that this technique allows the surgeon to visualize all of the structures they are working on. A major disadvantage is the number of incisions.

Closed Sinus Lift

During a closed sinus lift, no incisions are made in the gums. The entire procedure is performed through a single hole in which the dental implant will eventually be inserted. A closed sinus lift can only be performed if your residual bone height is at least 4–5 millimeters.

Advantages of a closed sinus lift include fewer incisions, reduced surgical time, and the possibility that the implant can be placed immediately following your sinus lift. A major disadvantage of this surgical technique is that the surgeon cannot directly visualize the structures they are manipulating.

Contraindications

Not everyone is a good candidate for a sinus lift, including:

  • People undergoing certain types of cancer treatment
  • People with uncontrolled diabetes
  • Some people who have allergic rhinitis or chronic sinusitis
  • Individuals who smoke and cannot quit
  • People with alcohol use disorder

Potential Risks

Some of the risks vary by the type of procedure.

Risks of an open sinus lift include:

  • Accidental displacement of the bone graft (may occur during forceful sneezing or from blowing your nose too hard)
  • Failure of the bone graft to develop adequate blood supply (rare)
  • Sinusitis (inflammation of the sinuses)
  • Sinus membrane perforation (this risk is increased among smokers)
  • Bleeding

Risks of a closed sinus lift include:

  • Sinus membrane perforation
  • Benign paroxysmal positional vertigo (dizziness and imbalance)
  • Accidental displacement of the bone graft

How to Prepare for a Sinus Lift

Your healthcare provider will give you specific instructions to prepare for a sinus lift. Follow these exactly.

These instructions may include discontinuing certain medications for a period of time, such as aspirin, which can increase your risk of bleeding during the procedure. Instructions may also discuss getting authorization from your insurance provider, arranging for transportation, and scheduling time off work to recover.

Before your procedure, your healthcare provider will likely order X-rays or a special type of computed tomography (CT) scan called cone-beam computed tomography (CBCT). This helps them better visualize your jaw and sinuses to plan for the surgery and better identify any individual risks of the surgery.

Most sinus lifts are done under local anesthesia. However, if you are to receive general anesthesia or a sedative, you will be instructed to stop eating and drinking for a certain period before surgery.

Some healthcare providers may prescribe medications to be taken shortly before surgery (such as an antibiotic). If this is the case, make sure you follow these instructions precisely.

What to Expect on the Day of Surgery

While your experience may vary slightly based on your circumstances and the preferences of your healthcare provider, generally speaking, most people can expect the following on the day of their sinus lift.

You will likely be asked to fill out paperwork and answer some questions upon arrival at your appointment. Questions may include medication allergies, your general health, what medications you have used recently, and when the last time was that you had anything to eat or drink was.

You may be asked to remove contact lenses, metal jewelry, or dental appliances. Your blood pressure and other vital signs may be taken, and you may be hooked up to machines that monitor your vital signs.

You will be given a local anesthetic, which will numb the area of the surgical procedure and minimize discomfort. Local anesthetic usually lasts several hours.

Some people are also given a sedative. If you are given a sedative or put under general anesthesia for your surgery, you will not be permitted to drive yourself home after your procedure. In that case, be sure to arrange for someone else to drive you home.

After surgery, you may be monitored for a brief period. Before your discharge, you should be given verbal and written instructions on how to care for yourself at home, including any warning signs you may need to notify your surgeon about.

You may be sent home with several prescriptions. Commonly prescribed and recommended medications after a sinus lift include antibiotics, decongestants (such as oxymetazoline), antimicrobial mouthwashes, saline nasal spray, and pain medications, which may be prescription or over the counter (OTC).

Recovery

It is not uncommon to have some bleeding from your nose or mouth right after surgery, and you can expect some swelling. Your healthcare provider may instruct you to use ice packs to keep swelling down. You will probably need to keep your head elevated while sleeping for a few nights to help with this.

Some people may experience bruising around the surgical site. Make sure you know how much bleeding and swelling is too much and when you should notify your surgeon. Heavy lifting or strenuous activities may increase bleeding. Your healthcare provider should give you instructions on specific activities to avoid.

You will likely need to follow a special diet for a brief time following your sinus lift. Typically you can start drinking liquids and then progress to soft foods. You may need to avoid foods and drinks that are carbonated or acidic and may burn (such as lemonade or tomato juice).

Pain following a sinus lift is typically minimal, and you may only need OTC pain relievers such as Tylenol (acetaminophen) and Advil or Motrin (ibuprofen). If your healthcare provider has prescribed prescription pain medication, it is important that you use it only as prescribed.

Following your surgery, you need to be careful about sneezing and blowing your nose to avoid dislodging your bone graft. While you cannot necessarily avoid sneezing, it is recommended that you sneeze with your mouth open.

Some healthcare providers recommend you avoid drinking from a straw and significant altitude changes and activities such as scuba diving for a period. This is because these activities affect the pressure in your sinuses.

Your healthcare provider will likely want to see you for a follow-up appointment about a week after your surgery to check your progress and ensure your recovery is going well.

Long-Term Care

While every individual is different, a sinus lift takes approximately six months to heal fully, at which point you may be ready for dental implants. No long-term care should be needed related to the actual sinus lift after healing occurs.

Additional Sinus Lift or Bone Grafts

It is not uncommon for additional bone grafting or sinus lifts to be performed, especially if there was a need for an extensive amount of bone to fill a bone defect.

Summary

A sinus lift is a common surgical procedure in preparation for dental implant insertion. People who are undergoing some cancer treatments, have uncontrolled diabetes, or cannot stop smoking may not be good candidates for a sinus lift.

A sinus lift is done in a same-day surgery setting and typically under a local anesthetic. While uncommon, risks may include failure of the bone graft, sinusitis, or sinus membrane perforation.

A Word From Verywell

A sinus lift can greatly improve your chances of a successful dental implant procedure. Follow your healthcare provider’s instructions carefully. The information contained in this article may also help give you a general overview of the procedure and what many people can expect.