Open and closed sinus lifting: what is it, what is the difference, the pros and cons of the operation

Quite often, before installing implants, patients in the dental office may hear that they need to undergo a sinus lifting. It is necessary if you do not have enough bone tissue. What kind of operation it is, how it is done, and what risks can you expect — read on.

What is sinus lifting

Sinus lifting is a surgical operation that is used to build up bone tissue in the upper jaw in the area of the posterior teeth. This manipulation is carried out in cases when the patient needs dental implantation, but he does not have molars (large teeth, starting from the fourth), and due to this, there is not enough bone tissue to place the implants.

How is the sinus lifting surgery performed

Depending on the situation and the degree of bone tissue atrophy, there are 2 methods of performing this operation:

• Open sinus lifting;
• Closed sinus lifting.

The task of both the first and the second method is to raise the floor of the maxillary sinus and fill the gap with bone material, which will help to form its own bone tissue. What types of materials are there, you can learn more in the article "Materials for bone grafting".

It is necessary to do osteoplasty, since large teeth are located directly under the maxillary sinuses, which, in turn, contain nothing but mucous. Therefore, when the teeth are removed, the bone begins to lose its volume and “sag,” and the titanium implant will eventually have nothing to catch on since there will be an empty space after the thinned bone tissue.

Let's take a closer look at how open sinus lifting differs from closed one.

Difference between open and closed sinus lifting

Open sinus lifting

This is the classic method that dentists use the most. The entire operation of open sinus lifting proceeds under local anesthesia, after the introduction of which the gum is cut in the lateral part of the upper jaw, pushed aside, in the sinus region, and an inlet is made on the bone. Then, through this hole, the doctor comes to the mucous membrane that covers the sinus inside, it is also called Schneider's membrane. After that, using special surgical instruments, the dentist carefully so as not to damage the Schneider's membrane, lifts the sinus mucosa and pours bone material there. When the procedure is completed, the wound is sutured and it will be necessary to wait about 4-6 months until the complete formation of bone tissue, then install the implant.

Open sinus lifting is in many situations the only method of bone augmentation in the upper jaw.

Disadvantages

The main disadvantage of open sinus lifting is its high injury rate. After this operation, the patient may have large bruises, swelling under the eyes, in the chin or neck area. It will also be necessary to take antibiotics and pain relievers.

Closed sinus lifting

The closed sinus lifting technique is less traumatic as there is no need to make special incisions on the gums. During this operation, all manipulations pass through the hole intended for the installation of the dental implant. With the help of special surgical instruments, the doctor lifts the Schneider's membrane, creates an air cushion inside that prevents tears and then fills the formed space with bone material.

The undoubted plus of the closed sinus lifting is that if your initial bone volume was 3-4 mm, then the implant can be installed on the same day, immediately after the augmentation operation. In addition, in contrast to the open one, the closed sinus lifting practically does not leave behind bruises and swellings, and the recovery process is much easier and faster in general.

Disadvantages

The most important thing to do is to choose a professional doctor who will perfectly plan everything for you and perform the operation with high quality, since not all dentists know the technique of a closed sinus lifting and not all have enough experience.
Therefore, the only drawback of the operation is that it can be performed poorly. Due to the limited visibility, the dentist can accidentally touch the membrane and tear it, as a result of which the whole operation will go down the drain and it will be necessary to redo it.

When should an open sinus lifting surgery be performed and when closed one?

Open sinus lifting is performed for those patients who have practically no bone tissue left and the implant simply cannot be fixed. A closed sinus lifting operation is needed if the patient still has about 3-4 mm of bone. In any case, initially, you should undergo a full medical examination, take an x-ray, after which the doctor will already determine in what way it would be better to build up the bone.

Recommendations after operation

• You must not eat for two hours after the surgery. It is also prohibited to use spicy, hard, hot foods and drinks. You must not drink liquid through a straw;
• After each meal, rinse your mouth with a special antiseptic solution;
• It is strictly forbidden to puff out your cheeks, sneeze with your mouth closed, and also blow your nose after the operation, since in this case the membrane may break and all the bone material will be able to come out;
• Avoid smoking, flying, swimming, and diving if possible. Avoid overheating and hypothermia;
• If you have removable dentures, try not to use them for the first 2 weeks after surgery.

Sinus lifting contraindications

• Acute sinusitis;
• Cancer diseases;
• Autoimmune diseases;
• Lack of bone between the oral mucosa and the sinus mucosa;
• AIDS or HIV disease;
• Blood clotting disorder.

If you are interested in the price of sinus lifting, you can always find it in the "Prices" section of the website.