Sufficient bone height is critical for implant support and long-term success. Short implants have increased risk of failure, specifically in the back teeth where the forces of chewing are the most.
The amount of available bone is determined by clinical exam and a cone-beam CT scan. The planned site for the implants are then examined for the quantity and the position of the ridge and the proximity of vital structures such as the sinus.
There are several techniques available for augmentation of bone in the vertical dimension based on location, degree of bone loss, and amount of bone augmentation needed:
Treatment is generally provided in two stages. In the first stage, bone grafting is done to correct deficiency in height, width, or both. Following 6 months of healing, dental implants are placed and allowed to heal. Finally the implants are restored with the final teeth.
Dr. Harendra shahi is one of the most experienced and innovative Prosthodontist & Implantologist in the field of bone regeneration and grafting as well as implant placement & restoration.
Sinus lift bone grafting is indicated when the bone height is inadequate for implants in the back of the upper jaw due to proximity of the maxillary sinus. This occurs in the area of upper second premolars, first molars, and second molars. Following tooth loss, the maxillary sinus migrates downward due to local resorption and remodeling pattern. The migration of the sinus floor results in bone loss which often becomes inadequate for implant support.
Depending on amount of desired bone augmentation, a sinus lift procedure may be done either through a small window on the outer side of the sinus wall or through the site where the implant is placed. The sinus membrane is gently lifted creating a small pocket where the bone graft material is inserted. Sinus lift procedure can be performed at same time as the implant placement if there is at least 5 mm of existing native bone height. Otherwise, it is performed in two stages where the bone augmentation is completed and allowed to heal for 6 months before placement of dental implants.
The optimal bone material is combination of patient’s own bone and mineralized freeze dried bone available from bone bank. Small amount of bone can be obtained from the back of the lower jaw bone near the site of the wisdom teeth. In smaller bone height defects, bone bank by itself maybe used with great results. In-addition guided tissue regeneration membranes and Platelet-Rich Growth Factor are used to promote healing.
The sinus lift procedure is a minimally invasive procedure and is quite safe. It is a safe technique with predictable results. Infection is the only potential complication which can be prevented through good post-operative oral hygiene and use of antibiotics. The procedure requires only a small pocket where the bone graft is placed, hence it does not alter the sinus function in anyway.
Patients will experience some discomfort well managed by analgesics and swelling which resolves mostly within a week. Patients can return to work or school in 1-2 days.
