Songjeong-dong Dental Clinic: Is a Sinus Lift Always Necessary When There Is Insufficient Jawbone?

Hello, this is S Leader Dental Hospital, a Songjeong-dong dental clinic celebrating its 22nd anniversary since establishment this year.

Some patients are told during an implant consultation after losing an upper molar, “Your jawbone is insufficient, so a sinus lift is necessary.”

Because the procedure may appear more complex than a standard implant procedure, you may be concerned about whether surgery is truly necessary or whether other options are available.

To give you the conclusion first, not every patient with insufficient upper-jaw bone necessarily needs a sinus lift.

The decision should be made after comprehensively evaluating the height and width of the remaining bone, bone density, the shape of the maxillary sinus, and the location and length of the implant to be placed.

A sinus lift may be considered if the implant cannot be securely stabilized using only the remaining bone. However, if a certain amount of bone remains or the treatment plan can be adjusted, other options may also be considered.

Today, S Leader Dental Hospital, a Songjeong-dong dental clinic, will explain step by step why a sinus lift may be needed, when it is essential, and when other methods may be considered.

Where is the maxillary sinus located?

The maxillary sinus is an air-filled space located beside the nose and inside the cheekbone. It is relatively close to the roots of the upper molars, and its size and shape vary from person to person.

After an upper molar is lost, the jawbone that supported the tooth may gradually decrease. At the same time, the maxillary sinus may expand downward, further reducing the height of the bone available for implant placement.

In particular, if a person has been without a tooth for a long time or has lost a significant amount of bone due to periodontal disease, there may not be enough space to stabilize an implant in the upper molar area.

What is a sinus lift?

A sinus lift is a procedure in which the thin membrane covering the maxillary sinus is carefully raised to create space beneath it where bone can form. When necessary, a bone graft material is placed in this space to supplement the height of the jawbone that will support the implant.

The surgical approaches can be broadly divided as follows.

Crestal approach

This method gradually raises the sinus membrane through the site where the implant will be placed. It may be considered when a relatively sufficient amount of jawbone remains and only a small amount of bone augmentation is needed.

Lateral approach

This method involves approaching from the side of the gum, creating a small window, raising the sinus membrane, and then applying bone graft material. It may be considered when little residual bone remains or when relatively extensive bone augmentation is needed.

The appropriate method is not determined solely by bone height. The width and density of the bone, the internal structure of the maxillary sinus, the condition of the membrane, and the possibility of achieving initial implant stability must also be evaluated together.

A sinus lift is not always necessary even when there is insufficient jawbone.

The need for a sinus lift depends not simply on whether the bone is “insufficient,” but on how much bone is lacking and whether the implant can be securely stabilized using the bone that remains.

Even patients with the same bone height may require different treatment plans if their bone width and density, maxillary sinus shape, or the position required for the prosthesis differ.

Therefore, rather than making an immediate decision based only on a panoramic X-ray, a three-dimensional CT scan should be taken when necessary to examine the following details carefully.

• The height and width of the jawbone at the implant site

• The shape and density of the remaining bone

• The thickness and condition of the sinus membrane

• Septa within the maxillary sinus and the presence of inflammation

• The distance from the roots of neighboring teeth

• The location and direction of implant placement

• The possibility of achieving initial implant stability

When a sinus lift may be considered

1. When the jawbone height in the upper molar area is insufficient

An implant must be firmly secured in the jawbone to withstand chewing forces stably. However, if the bone between the floor of the maxillary sinus and the gum is excessively thin, it may be difficult to place the implant in the proper position.

In this situation, raising the sinus membrane to create space for the implant and supplementing the insufficient bone may be considered.

2. When a long time has passed since tooth loss

As time passes after a tooth is extracted, the jawbone in that area may gradually resorb. In the upper molar area, the bone may decrease while the maxillary sinus expands downward, further reducing the available bone height.

3. When jawbone has been lost due to periodontal disease

Severe periodontal disease can destroy the jawbone around a tooth. If there is not enough bone to support an implant after tooth extraction, bone grafting and a sinus lift may be considered together.

4. When it is difficult to achieve initial implant stability

Initial stability refers to the implant being firmly secured in the surrounding bone immediately after surgery. If the remaining bone is too limited or has a low density, making stable fixation difficult, a sinus lift may help improve the conditions for treatment.

When other methods may be considered instead of a sinus lift

There are also cases in which a sinus lift is not necessary or another treatment plan may be considered. However, the methods below are not suitable for every patient, and their respective advantages, disadvantages, and conditions for application must be evaluated.

1. When enough jawbone remains

If a three-dimensional CT scan shows that the implant can be securely stabilized using only the remaining bone, the implant may be placed without a sinus lift.

2. When a short implant can be used

If the biting forces, bone condition, and prosthesis position are suitable, a shorter implant may be considered. This may make treatment possible without significantly raising the maxillary sinus, but the bone width and density and the chewing forces must also be evaluated.

3. When the implant position or direction can be adjusted

The position or angle of the implant can be adjusted to make use of the remaining bone. However, this should not be chosen simply to avoid a sinus lift unnecessarily, since the direction in which chewing forces are transmitted and the shape of the final prosthesis must also be considered.

4. When a treatment other than an implant is selected

Depending on your overall health, the burden of surgery, and the condition of the neighboring teeth, other prosthetic treatments such as a bridge or partial denture may be considered. However, a bridge requires the use of neighboring teeth, while a partial denture requires an adjustment period and ongoing care, so the characteristics of each treatment should be compared.

Can a sinus lift and implant placement be performed at the same time?

If the remaining jawbone is sufficient to hold the implant, the sinus lift and implant placement can be performed in a single surgery.

Conversely, if the residual bone is extremely limited and it is difficult to achieve initial implant stability, staged treatment may be necessary. In this approach, the sinus lift and bone grafting are performed first, followed by implant placement after the grafted bone has stabilized.

Assess the need for a sinus lift carefully at S Leader Dental Hospital, a Songjeong-dong dental clinic

Insufficient jawbone does not automatically mean that a sinus lift is necessary. Depending on the height and width of the remaining jawbone, bone density, the structure of the maxillary sinus, and the possibility of achieving initial implant stability, treatment may be possible without a sinus lift, or the bone may be supplemented using a relatively simple method.

Conversely, if the residual bone is extremely limited, a sinus lift may be necessary to place the implant securely. Even in this situation, whether to perform the sinus lift and implant placement at the same time or to place the implant in stages after bone grafting first must be decided according to the patient’s condition.

At S Leader Dental Hospital, a Songjeong-dong dental clinic, we carefully evaluate the condition of the jawbone and maxillary sinus using three-dimensional CT scans and oral examinations, and provide an implant treatment plan suited to each patient’s oral condition.

If you are wondering whether a sinus lift is truly necessary before receiving an upper molar implant, rather than rushing to decide whether to undergo surgery, we recommend receiving a thorough consultation about the condition of the bone that remains and the treatment options available to you.

Songjeong-dong Dental Clinic :: S Leader Dental Hospital.