Consent for Maxillary Sinus Elevation Surgery

There is not enough bone height in your upper back jaw, below the sinus, to hold dental implants of a suitable length. Your dentist has recommended a sinus elevation (sinus lift) to add bone in this area. Local anaesthetic will be used, with any other medication your dentist considers appropriate, and antibiotics may be prescribed.

The gum is gently moved aside and a small opening is made in the bony wall of the sinus. The thin lining of the sinus is lifted, and graft material is placed underneath. The graft may be your own bone, a synthetic substitute, processed human or animal bone from a tissue bank, or a mix. A membrane may also be used. Some membranes need a small second procedure to remove them.

Implants may be placed at the same visit or after the graft has healed, which can take several months. This often cannot be decided until surgery. Unexpected findings can mean the procedure cannot be started or finished as planned, which may change your treatment plan or lead to a referral to a specialist. You consent to reasonable changes your dentist considers necessary.

The expected benefit is enough bone in the upper jaw to support implants.

Possible complications include:

• infection, bleeding, swelling, pain and temporary bruising of the face;
• nosebleeds;
• sinus infection (sinusitis), or a flare-up of existing sinus problems;
• looseness or sensitivity of nearby teeth to hot, cold, sweet or acidic foods;
• gum shrinkage that makes some teeth look longer or leaves larger gaps between them;
• rarely, nerve injury, or infection spreading to other areas, including the bone; and
• failure of the graft, which can lead to implant failure or make implants impossible later.

These complications are possible but not likely, and careful planning prevents most of them. Some may not be reversible, and a second procedure may be needed if the first result is not enough. Medical conditions, diet, smoking, alcohol, clenching or grinding, oral hygiene and some medications can all affect the result.

• No treatment, meaning implants of adequate length cannot be placed in this area.
• Shorter implants, which may be lost sooner.
• Grafting on top of the ridge instead, which may only gain limited bone.
• Implants anchored in bone behind the sinus, which carry their own risks, including bleeding and nerve injury.
• Removable partial or complete dentures, which may become less comfortable as bone loss continues.

Follow all instructions and prescriptions, and see your dentist and regular dentist for checkups. Contact us promptly about nosebleeds, pain, unusual sinus pressure, fever, swelling, pus or reactions to medication. We will tell you when your next visit is due, but booking it is your responsibility.

Sinus elevation is a well-established procedure. As with any surgery, though, no guarantee of success can be given.