3.7\ Sinus Lift Procedure

3.7.1\ Discussion

The sinus lift or augmentation procedure is performed to build up a deficient maxillary alveolus for subsequent osseointegrated dental implant insertion. The procedure involves accessing the maxillary sinus and elevating the mucous membrane at the inferior aspect of the maxillary to create a space in the floor of the sinus where bone graft material is inserted, typically with a

dome-shaped configuration on coronal images (Fig. 3.11). The bone graft initially has a porous appearance but consolidates with a more uniformly hyperattenuating appearance on CT as osseointegration and osteogenesis ensure after 6–8 months. Disruption of the sinus mucosa may result in sinusitis, graft infection, or formation of oroantral fistula, which is best depicted on coronal plane CT images (Fig. 3.12). Furthermore, graft material scattered in the sinus may also indicate surgical failure.

Fig.3.12  Sinusitis and oroantral fistula after sinus lift procedure. Coronal CT image (a) shows bilateral sinus lift procedures with osseointegrated implants and opacification

of the right maxillary sinus. Follow-up CT image (b) shows a defect in the maxillary sinus floor (arrow) and persistent right-sided sinus opacification