Bone Supplementation, Sinus Lift

As a result of an injury or tooth-less status the size and bone substance of the jaw can be reduced. If bone loss outweighs a critical limit, an implantation surgery or tooth replacement cannot be performed without bone supplementation, as there is not enough bone substance to incorporate the implant.
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Bone supplementation procedures can be performed by using different type of substances and surgical techniques.

Types of surgical interventions and course of the operation
Sinus lifting is a method to increase the height of the upper jaw bone. During this procedure we increase the height of the bone itself. In order to increase the width of the jaw bone we perform only plastic surgeries during which increasing of the jaw bone width is done by bone supplementation or by using own bone parts. Surgical sites are then covered with different types of membranes, and after 4-6 months of osteointegration the implantation can be performed.

In case of large extents of bone substance loss, size of our own wasted jaw bone can be augmented by using an own so-called bone block. During this procedure we can gain bony substance from our chin, from behind the wisdom teeth of the mandible or – if larger amount of bony substance is needed – from the iliac crest. These bone parts are attached to the jaw bone with titanium screws, then spaces are filled with synthetic bone and the surfaces are covered with membranes. Screws are removed after the bone supplementation, mainly during the implantation surgery.

Bone block surgeries – during which the bone parts are removed from the chin or from the region behind wisdom teeth – are ambulatory operations, while surgeries affecting the iliac crest are performed in oro-surgical operating rooms.

Sinus lift surgery (sinus lift, sinus elevation)
This intervention has to be performed if we plan an implantation, but the height of the bone is not enough in case of upper small molars or large molars, implantation cannot be performed as the bone is not capable of incorporating the implant. In such cases a sinus lift-combined bone supplementation is done to increase the height of the upper jaw bone.

Course of the sinus lift surgery
After the explorative surgery we lift the mucous membrane of the sinus through a bone window created on the outer surface of the sinus, we place synthetic or own bone between the mucous membrane and the bone, and finally we close the mucosa.
After 4-6 of healing the implanted bone supplementing substance becomes our own bone.
After the healing period, during another surgery, we place the implants into the newly developed bone, onto which bridges can be placed later.
If we are lucky the implantation can be performed at the same time with bone supplementation. But it is only possible if the size and height of our bone is enough to incorporate the primary attachments of implants. During this procedure the implant neck is located in the bone, its tip is in the bone supplementing substance, which ossifies together with the implant placed.