Sinus Graft
Preparing the Bone to Place an Implant in a Healthy Physiologic Environment
Dr Yvan Gaudex
Do you need a dental implant in the upper jaw but were told there isn’t enough bone? Perhaps a “sinus graft” was mentioned.
Despite its intimidating name, this is a well-established technique commonly used in implant dentistry to create the bone conditions required for implant placement, particularly in the upper jaw where the sinus is (also called “posterior maxilla”).
With this procedure, a solid anchorage can be restored even when imaging suggests insufficient bone height.
Why is the sinus involved in implantology?
In the upper jaw, just above the back teeth (premolars and molars), lie the maxillary sinuses—air-filled cavities within the facial bones.
After a tooth is lost in this region, the supporting bone naturally resorbs over time, and the sinus may “pneumatize” downward (i.e. your sinus will expand to the detriment of your bone), further reducing the bone height available for an implant.
In such cases, placing a standard implant risks perforating the sinus. A sinus graft—also called a sinus floor elevation—lifts the Schneiderian membrane upward and recreates a space where new bone can regenerate.
Purpose and steps of a sinus graft
The goal is to recreate sufficient bone volume between the sinus floor and the oral cavity so one or more implants can be placed safely and stably.
Performed under local anesthesia in strictly sterile conditions, the procedure typically includes:
- Creating a small access window through the gum and the lateral wall of the maxilla to reach the sinus floor.
- Gently elevating the sinus membrane without tearing it.
- Inserting a bone graft material sometimes supplemented with factors that promote natural bone regeneration.
- Allowing the graft to act as a scaffold for new bone; when indicated, covering it with a protective membrane (guided tissue/bone regeneration).
When initial bone thickness is favorable, the implant can be placed at the same time, avoiding a second surgery.
When is a sinus graft recommended?
- When residual bone height under the sinus floor is < 7–8 mm, making conventional implant placement too risky
- Following long-standing extractions with marked posterior maxillary bone resorption
- As part of an implant plan in an area edentulous (i.e. without teeth) for a long time
- To improve the stability, longevity, and comfort of a future implant when the existing bone is too thin or fragile
This approach allows many patients previously deemed ineligible for implants in this region to benefit from a reliable, durable, and aesthetic solution.
Post-operative course: what to expect
Recovery is usually straightforward and well tolerated:
- Moderate cheek or infra-orbital swelling, sometimes with a mild sense of sinus pressure
- Temporary nasal discomfort due to the proximity of the surgical site
- Short-lived fatigue over the first few days
With appropriate anti-inflammatories/analgesics, meticulous oral hygiene, and strict adherence to post-operative instructions, healing is typically uneventful.
Key advice includes avoiding sudden efforts, not blowing the nose forcefully, and limiting pressure changes (air travel, diving) during the first weeks.
When can the implant be placed?
Timing depends mainly on:
- The initial bone volume present before grafting
- The quality and stability of the graft material used
Accordingly:
- Simultaneous placement is possible when conditions are favorable (implant placed the same day as the graft).
- Delayed placement requires about 4–6 months for adequate bone regeneration and implant stability.
Radiographic or 3D imaging is used to confirm satisfactory regeneration before proceeding.
CONCLUSION
Sinus grafting is a reliable, proven, and now routine technique in modern implant dentistry. It effectively addresses bone deficiency in the posterior maxilla and enables safe implant treatment—even years after tooth loss.
Dr. Gaudex will provide a comprehensive, personalized assessment to determine whether a sinus graft is indicated in your case and will guide you through each step with a detailed, rigorous approach.
