Treatments / Oral & maxillofacial surgery
Bone Grafting & Sinus Lift
Bone shrinks after a tooth is lost, and sometimes there is not enough left to hold an implant. Grafting rebuilds it, and a sinus lift creates height in the upper back jaw where the sinus sits low. Both are planned from a CBCT scan rather than guessed at.
Who this is for
- A tooth site that has been empty for years
- Upper back teeth where the sinus limits the bone available
- Bone lost through gum disease or infection
What actually happens
- CBCT scan and measurement of the site
- The graft or sinus lift under local anaesthetic
- A healing period before implants are placed
What ridge augmentation and a sinus lift are
After a tooth is lost, the ridge of jawbone that held it slowly becomes narrower and lower. Ridge augmentation is the clinical name for building that ridge back up: graft material is placed where the bone has thinned, so an implant will have enough bone around it.
A sinus lift deals with a different problem. Above the upper back teeth sits the maxillary sinus, an air space, and once those teeth are gone it often dips lower into the jaw. A sinus lift gently raises the lining of the sinus floor and places graft material beneath it, which gives the implant more height to sit in.
Graft material can also be placed in a socket at the time a tooth is removed, to limit the shrinkage in the first place.
With the implant, or as a separate step?
It depends on how much bone is missing. A small shortfall can sometimes be grafted at the same appointment as the implant. A larger one usually means the graft goes in first and is left to heal, and the implant is placed later. Either way the graft is planned and costed as its own step.
A sinus lift works the same way. If only a little extra height is needed, it can sometimes be done with the implant. If more is needed, the lift is usually a procedure of its own, with the implant placed once it has healed.
The CBCT scan decides which route applies. It shows the height and width of the bone in three dimensions, how low the sinus sits and where the nerve in the lower jaw runs. An ordinary X-ray does not show the width of the bone.
What healing involves
Grafting is usually done under local anaesthetic. A graft placed at the same appointment as an implant is done at the clinic, like the implant itself. Over the months that follow, your own bone gradually grows into the graft, and that new bone is what holds the implant. How long it needs depends on the size of the graft, and Dr Kuchu will tell you what to expect in your case.
Some swelling, bruising and soreness for a few days is common. After a sinus lift you will usually be asked not to blow your nose hard, and to sneeze with your mouth open, while it heals.
If swelling keeps spreading towards the eye or into the neck, if swallowing, breathing or opening your mouth becomes difficult, or if you have a high fever or bleeding that will not stop, go to a hospital emergency department straight away, and call 108 if breathing is difficult. These are not part of normal healing.
Bone grafting and sinus lifts are done by Dr. Bhargav Kuchu, our oral and maxillofacial surgeon.
Questions people ask
Is ridge augmentation the same as bone grafting?
It is one kind of bone grafting: the kind that rebuilds the ridge of jawbone where teeth used to be. A sinus lift is another kind, used only in the upper back jaw.
Does every implant need a bone graft?
No. Many implants are placed without any grafting. Whether you need one depends on how much bone is left at the site, which the scan shows.
Where does the graft material come from?
It can be a small amount of your own bone, or a prepared graft material. Some prepared materials are animal-derived, so if that matters to you, say so at the consultation and the options will be explained.
Is bone grafting painful?
It is done under local anaesthetic, so the area is numb during the procedure, and you can say if you feel anything sharp. Soreness and swelling for a few days afterwards are common, and you will be told what pain relief to take.
Does a graft add to the cost of an implant?
Yes. It is a separate part of the treatment with its own cost, and it is included in the written cost you get before anything starts.
