MAXILLARY SINUS :
The human skull contains several air spaces called sinuses, which are connected to our air passages.They have no particular function, but it is theorised that they make the head lighter. Maxillary sinus is located in the upper jaw directly above the molar and bicuspid teeth.
sinus lift :
OR sinus elevation is a bone grafting procedure that builds bone volume below the maxillary sinus before a dental implant can be placed. When upper back teeth are lost, bone in that area naturally shrinks or resorbs over time. Consequently your sinuses expand to occupy the empty space where the bone used to be.
Because there is insufficient bone available to securely place the dental implant, your implantologist might suggest sinus lift in order to create space for placing additional bone in that area. Sinus lift requires a complex surgical procedure and waiting time for a final prosthetic work on implants in that region might last even up to a year.
Sinus lift also known as Maxillary sinus floor augmentation, is a surgical procedure intending to boost the quality of the bone in the distal half of the upper jaw.It is done by placing the bone grafts after lifting the lower Schneiderian membrane.
After the tooth loss in the upper premolar and molar area, the Alveolar process starts to redesign the vacant bare socket as it caves in during the healing process, leaving behind a tooth less area called the Ridge.There will be loss in both width and height of the bone due to collapse which ultimately results in bone deficiency,posing a challenge for implantation in that area, which is very crucial for teeth replacement.Main aim of the sinus lift procedure is to do bone grafts in the sinus area so that, it facilitates implantation procedure.
Descending of the Sinus can be caused not only due to long term tooth loss but also due to trauma, periodontal disease and it also continues to enlarge with age and an individual will have very little bone left in that area as he ages.
SINUS LIFT PROBLEMS
It is a very intrusive measure which results in extensive inflammation and bruising.The others being
- Tear in the Sinus membrane.
- Soreness and pain.
- Tissue or nerve damage.
- Oroantral fistula.
- Implant failure.
Recovery time will be around 6 to 8 months before implantation procedure can be attempted but, in very few cases sinus lift is accompanied immediately by implantation.
Sinus lift involves,repeated surgeries such as, a procedure to extract bone from the donor site for bone grafts, followed by a surgery to place the obtained graft material in the required area, succeeded by two more surgeries, one for the implant placement after 6 to 8 months and an other for the exposure of the implant.
In recent times sinus lift is considered as an out dated procedure as permanent teeth in 3 days cases are being preferred and also many alternatives to sinus lift procedure have evolved over time, as rehabilitation in the distal maxilla has always posed problems to the implantologists due to the anatomy of the sinus,poor quality and quantity of bone and also due to improper access.To overcome this along with sinus lift and bone grafts other procedures like short implants and tilted implants have been proposed but they have their own limitations. The ultimate solution for this situation is affordable implants, which help in restoring the upper posterior grinders by placing tuberopterygoid Implants in the distal half of the upper jaw, they act as an substitute to avert sinus lift complications and bone grafts. The basal implant cases using the tuberopterygoid Implants have a very high success rate with minimal complications as the Pterygoid bone is highly mineralised and is not prone to resorption.The tuberopterygoid Implants also cut down the full denture implants cost, and also provide life time warranty.
DISADVANTAGES OF SINUS LIFT:
- Bone Grafts Failure:Sometimes bone grafts material does not integrate with existing bone due to poor blood supply.
- H/O Repeated Sinusitis:Patients with a repeated history of sinusitis we cannot subject them to this procedure.
- Cost of Sinus Lift:Apart from the surgeons charges , bone grafts material is very expensive.
- Very Invasive:Patients are often subjected to repeated surgeries.
- Time Consuming:Often 6 months to 1 year,if the implant is placed along with sinus lift, patient has to wait for 6 months before teeth are fixed. In cases where placement of implant is delayed (alveolar height less than 5 mm) 4 months for bone graft to osseo integrate and 6 months for implant osseo integration.
HOW DO WE MANAGE: by two methods!
- Sinus Bypass: With tuberopterygoid Implants.
One implant is placed anterior to sinus with distal tilt and one placed posterior to sinus with mesial tilt.
- Trans Sinus Implants: basal implants provide simple,less invasive and cost effective alternatives to sinus lift procedure, where patients can get fixed, functional permanent teeth in 3 days