The maxillary sinus is always a consideration when placing dental implants in the posterior upper jaw. Oftentimes the floor of the maxillary sinus scallops around the roots of maxillary molar and premolar teeth. This is particularly true with maxillary first molars (#3 and #14) and maxillary second molars (#2 and #15). As a result, when these teeth are extracted there may not be adequate bone height to support dental implants in the posterior maxilla without grafting.
When there is inadequate posterior maxillary vertical bone height to support dental implants, a sinus lift or bone graft to the floor of the maxillary sinus is indicated. A small window is made in the anterior wall of the maxillary sinus with special burrs. These burrs were developed to cut a window in bone without cutting the underlying tissue. In other words, a window of bone can be removed safely without cutting or without tearing the sinus membrane. The sinus membrane is then carefully elevated. Most often a resorbable collagen membrane is placed in the sinus against the sinus membrane to protect the sinus membrane while bone graft material is placed on top of the floor of the maxillary sinus.
Several types of bone graft materials can be used for a sinus lift. These materials include autogenous bone (the patient’s own bone), allogenic bone (freeze-dried cadaver bone), bovine bone (cow bone), and BMP (bone morphogentic protein). A sinus graft will oftentimes take six months to heal, after which dental implants can be safely placed into the grafted sinus.
A cone beam scan, or an ICAT scan, is an in office CAT scan unit which allows the oral surgery specialist to see the bone in a three-dimensional relationship. This allows the dental implant surgeon to measure the width and the height of the bone. This is especially helpful when evaluating the posterior maxilla to determine if there is enough bone for placement of dental implants. By mapping out the existing bone, the dental implant surgeon can determine if the area needs a sinus lift or bone graft in order to place dental implants.
It is a goal of Dr. Baker and Dr. Jepsen at Facial & Oral Surgery Associates to minimize the number of surgeries for patients and to maximize aesthetic outcomes. When possible Dr. Baker and Dr. Jepsen will extract the teeth, place an implant, and complete a simultaneous sinus lift, or mini sinus lift, all in the same surgery. Sometimes it is necessary to do two separate surgeries. The first surgery would include extraction of indicated teeth and completion of the sinus lift. The second surgery would be placement of the dental implants. These surgeries are oftentimes completed under IV sedation so that the patient can be relaxed, asleep, and comfortable for their surgery.
A retrospective review was recently completed of dental implants placed at Facial & Oral Surgery Associates from March 2007 to March 2014. During this seven-year window, 4,635 implants were placed by three surgeons at Facial & Oral Surgery Associates. Dr. Baker and Dr. Jepsen are pleased to report their implant success rate of 99.8%. This is well above the national average and is an extraordinary outcome. There were 511 dental implants placed during that seven-year window in the posterior maxilla, mostly to replace first molars (#3 and #14), but also to replace second molars (#2 and #15). It was estimated that approximately 1/3 of these posterior maxillary dental implants were placed into sinus lifts or into bone grafted sinus areas. With a 99.8% success rate with dental implants, it is clear that a sinus lift is a very successful procedure.
A key to successful dental implants is to place dental implants into a good foundation of bone. A sinus lift is a successful procedure that allows the dental implant surgeon to place implants in the posterior maxilla when the bone is inadequate.
In conclusion, it is clear that a sinus lift is a very successful procedure when completed by experienced dental implant surgeons. Dr. Baker and Dr. Jepsen attribute their remarkable success rate to over thirty-seven years of combined surgical experience in all aspects of Oral and Maxillofacial Surgery. Dr. Baker and Dr. Jepsen are pleased to report their success rate of 99.8%, which is well above the national average.