The name for this procedure is a “maxillary sinus floor augmentation” but you may also hear the terms “sinus augmentation” “sinus lifting” and “sinus graft” used. One of the major problems when trying to place implants in the upper jaw is that the maxillary sinus limits the amount of available bone height for the implant.
The way to encounter this is to lift the floor of the maxillary sinus and use bone to fill in the space created. It is a time-consuming and invasive procedure which has many complications. The complications can arise during the surgery itself but also afterwards.
In addition, complications can arise from the bone graft that has been placed. The bone-graft can be from your own body such as the lower mandible or another bone altogether such as in the hip or the leg. These are known as auto grafts and are not very popular now.
The bone can come from a different human being altogether and these are known as allografts.
Bone can also be used from cow bone or pig bone known as a xenograft.
Finally, there are a number of synthetic bone materials currently in use. These tend to be the preferred option nowadays.
It is interesting to note that maxillary sinus floor elevation without a bone graft results in new bone formation and a high implant survival rate instead of maxillary sinus floor augmentation with bone grafting.
The most common complications of a maxillary sinus augmentation procedure are the perforations of the schneiderian membrane which lines the floor of the sinus. A small tear or hole is not very problematic however a larger one means that the procedure has to be abandoned until healing has occurred in order to re-operate.
As with any surgical procedure, infection can occur and this is no exception with a maxillary sinus lift procedure. Pre-antibiotics and post-operative antibiotics are usually given but when an infection does occur and cannot be controlled, the procedure will be deemed to be failing and the infection needs to be controlled before an implant can be placed again.
Complications with bleeding do arise because there are a number of major blood vessels in the anatomical area. The infraorbital artery is a frequent one that is torn and this results in severe bleeding.
It is not uncommon for an implant to be pushed up past the floor of the maxillary sinus and the implant has gone astray. Another procedure has to be carried out in order to retrieve the lost implant.
Benign paroxysmal positional vertigo is one complication that can occur after a maxillary sinus augmentation and is particularly unpleasant for the patient. It can be temporary and is controlled by appropriate medication however it can become a permanent problem which is troublesome for the patient.
Complications seem to be more prevalent if the patient has an underlying health condition or is a smoker. For instance in smokers, perforation of the membrane is more common and that is because the schneiderian membrane is thinner in smokers. Another common underlying health condition is diabetes and these patients heal much less quickly and more poorly than normal healthy patients.
Chronic sinusitis is also fairly common and patients experience a different array of symptoms such as headaches, blocked nose, facial pain, changes in sensation when the head position suddenly changes, difficulty breathing through the nose, nasal obstruction and tenderness around the area. In acute sinus infection, facial pain, swelling is increased with purulent nasal discharge.
Due to all the possible complications of maxillary sinus lift operations, it is important to discuss with your dentist if there are any other viable options such as using shorter implants, using internal sinus lift technique which is less invasive and placing implants in a different region.