Sinus lift is a very reliable surgical technique that aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region. Pre-prosthetic surgery is usually necessary prior to implant to ensure optimal results from a dental restoration.
The procedure is relatively simple and complications are very rare, High success rate and long-term results have been proven. Primary aim of sinus floor elevation is to increase the vertical bone height of the alveolar bone to create enough bone density to support the implant. Sinus lift and implant-prosthetic rehabilitation ensure recovery of aesthetics, phonetics and function as well as patient's self-esteem.
The procedure is performed on patients whose available bone height in the posterior part of the maxilla is insufficient for implant placement due to pneumatization of the alveolar process after tooth loss. The space created in the raised sinus membrane is filled with augmentative material that adds volume and density to patient's jaw in areas where bone loss has occurred, in order to enable permanent stability of the implant. Prerequisite for the correct performance of the procedure is good knowledge of the anatomical variation of bones, mucous membrane of the maxillary sinus, as well as the position of blood vessels and nerves. The surgery is safely and painlessly performed under local anesthesia. Preoperative assessment includes a thorough general medical and dental history, clinical examination and radiological diagnostics (CBCT and X-ray), which determine the anatomical shape of the sinuses, the height of the bone ridge or possible pathological changes, which would be one of the contraindications for the sinus lift procedure (primary sinusitis, cysts or tumor masses).
The rising demand for dental implants continues, so one should bear in mind that continuous information flow and good knowledge are an extremely important factors in today's dental practice: it is necessary to know what types of therapy are available, what are the advantages and disadvantages of each therapy, and how to transfer knowledge to the patient clearly and effectively.
Sinus lift methods can be divided into:
• classical (open and closed technique, i.e. lateral and crestal approach) and
• modern approaches (balloon-lift-control and piezosurgery).
The bone defect can be either derived from biological products, synthetic or substitute (animal) materials.
INDICATIONS AND CONTRAINDICATIONS
The sinus lift procedure aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region.
Contraindications can be classified into three categories: medical, intraoral and local. Medical contraindications refer to chemotherapy or radiation therapy used to treat head and neck cancer during the sinus lift procedure or during the following six months; immunocompromised patients, diabetes, drug and alcohol addiction, acute, chronic or allergic sinusitis and rhinosinusitis, as well as patients with psychiatric conditions. Intraoral complications would be scars on the oral mucosa or hypofunctional mucosa, cysts, local benign or malignant tumor. Local complications include inner ear problems, vertigo and oblique maxillary sinus floor. Piezosurgery (using piezoelectric vibration energy) is contraindicated in patients with implantable cardiac devices.
Although the sinus lift has become a routine procedure, along with the surgeon's expertise and manual dexterity, which are the key to success in implant-prosthetic therapy, it is necessary that a clinician posessess a good anatomical knowledge, reliable knowledge of morphology of the maxillary bones, is familiar with advantages and disadvantages of each sinus lift method and is aware of indications and contraindications for surgical treatment. Establishing correct diagnosis and treatment plan is a basic prerequisite for a successful dental procedure.