Frequently asked questions

Sinus Grafting Procedures

 

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What is sinus grafting?

Sinus grafting is a particular type of bone grafting procedure used to build up the bony volume at the back of the upper jaw.

It is used to facilitate the placement of implants for the replacement of missing teeth at the back of the upper jaw.

 

Why would I need this procedure?

Generally, once teeth have been removed, the bone that was supporting them is slowly lost over time and in particular, this loss can be quite marked in the back of the upper jaw.

The air sinuses which are within the cheekbone and a normal anatomical feature may also enlarge slowly over time into the areas where the roots of the upper back teeth were.

The end result is a reduction in both bone quantity and density. This situation needs to be corrected if the intention is to replace the missing teeth with implant-supported restorations as sufficient bone has to be present to surround the entire length of the implant.

 

How is the sinus graft procedure carried out?

As with all implant-related treatment, the surgeon and nursing staff follow a strict sterile protocol in the surgery.

The gum tissue on the cheek side of the upper jaw is temporarily lifted up to expose the bone for the grafting procedure. A small window is created in the bone to access the sinus lining which can then be gradually raised. This creates a space for the placement of the graft material which will maintain the new raised position of the sinus lining.

Once sufficient graft material has been placed, a special membrane is secured over the window in the jaw bone to provide a seal and then the gum tissue is placed back in its original position.

 

sinus grafting procudure

 

Sinus grafting can be carried out under local anaesthesia alone or with additional intravenous sedation if required. This is inherently a more pleasant way of having potentially stressful surgical treatment carried out and is especially good if you are apprehensive as the sedative’s action actually removes anxiety, so making the treatment much more comfortable.

These options can be discussed with you during a consultation appointment.

 

What is the graft material?

The graft material (“Bio-Oss”) and special membrane (“Bio-Gide”) are produced by Geistlich Biomaterials (www.geistlich.co.uk). The graft material is a bone substitute of bovine origin; the membrane is a collagen of porcine origin. Both have been thoroughly treated to remove all proteins and sterilised to ensure safety. The bone substitute initially acts as a scaffold but over time, it largely dissolves away to be replaced by your own bone.

“Bio-Oss” and “Bio-Gide” have been comprehensively researched and validated for use in this and other bone grafting procedures; detailed patient information booklets regarding these materials are available.

 

Can implants be placed at the same time?

It is sometimes possible to place an implant at the same time as the grafting procedure if there is sufficient quantity of jawbone already present at the operation site to stabilize the implant. The grafting procedure will lead to the rest of the implant becoming surrounded by new bone over time.

If it is not possible to place the implant(s) during the procedure, the graft will need to be left to mature for around 10 months before the implants are placed as a separate procedure.

Whether one or more procedures are likely to be required will be assessed during a consultation appointment.

 

How long will the operation take?

This depends on the degree of grafting required and whether the operation is being carried out with local anaesthesia alone or with additional intravenous sedation.

An appointment for surgery under local anaesthesia usually lasts 90 minutes. When intravenous sedation is used, an appointment usually lasts 120 minutes. The longer time allows for the recovery period needed before you can be discharged home.

 

Will there be any stitches?

Stitches are used in the operation to help complete the surgery. A fine size of thread is used to achieve a good cosmetic result.

These stitches are dissolvable and so should disappear after about two weeks.

 

Will I be in pain afterwards?

You should not feel any pain immediately after the operation, as the area of surgery will be numb from the local anaesthetics that have been used.

As the numbness wears off, the area might become uncomfortable and then you should take painkillers. We will supply you with these, with information about dosage.

 

Could there be any complications or after-effects?

At the time of the procedure, if any infection is found around the operation site, it might be necessary to defer the surgery and instigate the appropriate treatment to resolve this infection.

The sinus grafting procedure requires careful management and handling of the lining of the sinus (which is a delicate structure). If the lining develops a small tear during the procedure, this might be repairable prior to the placement of the graft. However, it is possible that the grafting procedure might have to be postponed to allow the tear to repair itself (usually over a 3 month period).

After the procedure, there is likely to be some swelling and bruising in the area of the surgery and possibly some discomfort. The bruising is usually most obvious after two to three days and varies in amount between patients. It normally resolves in 10 to 14 days.

Some minor nose bleeding and congestion may also occur and to reduce the likelihood of the graft becoming displaced, it is very important to avoid all nose blowing for at least 2 weeks. 

 

When can I return to work?

This depends on your occupation and how you are after your treatment. It may be possible to return to work the next day.

Some people need to take some time off work, especially if the operation has been carried out under intravenous sedation. We will give you appropriate advice for your particular circumstances.

 

After your operation

After your surgery, we will give you an information sheet with instructions to help bring about a quick recovery.

We will discuss this with you before you are discharged home, to ensure that the information is clear and understood.

The main points are as follows.

On the day of the operation

  • Get plenty of rest in the first few hours after your operation.
  • Do not rinse your mouth or drink hot fluids.
  • Relieve discomfort by taking the supplied painkillers as directed and use ice packs to reduce discomfort at the operation site.

 

From the following day

  • Keep your mouth as clean as possible by gently brushing your teeth as usual.
  • Use salt water mouth rinses (one teaspoon of salt in a cup of warm water) every four hours for seven days. This will help to keep the operation site clean and clear of debris.
  • Avoid smoking. The local action of nicotine in the mouth has been shown to have a detrimental effect on healing after surgery and greatly increases the likelihood of wound infection developing.
  • Continue to take the painkillers and any other supplied medications as directed and use ice packs for the next two to three days.
  • If bleeding is troublesome, you can usually control it by placing dampened gauze over the wound and applying pressure for 15 to 20 minutes (slight oozing can be expected for a short time following surgery).

 

If you have any other complications or require advice after treatment, please call 07790 203198 and leave a message including a contact telephone number. We will return your call as soon as we can.