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The Major Maxillary Sinus Lift or simply “Sinus Lift,” is a surgical technique that uses the cavity of the maxillary sinus to insert osteo-integrating biological material with the aim of augmenting the superior molar and pre-molar bone elevation.
The term “sinus lift” indicates a series of surgical interventions that aim to lift the sinus membrane to create a space between it and the sinus floor in which to insert biomaterial to augment the volume of the remaining bone.
Often, because of sinus hypertrophy or because of bone resorption owing to infections or traumatic extractions, the volume of the bone in the posterior maxillary area is not sufficient for the insertion of an implant fixture. In this case, a sinus lift is the gold standard for bone reconstruction and has a more elevated success rate than any other surgery with the same aim.
Two similar operations use different access points. One is known as major sinus lift and the other as closed sinus lift. The difference between the two lies in the area chosen to access the maxillary sinus.
In the major sinus lift, you raise a vestibular flap and make an incision in the area below the zygomatic bone, on the sinus’s vestibular wall. You detach the sinus membrane and turn over the incision so it becomes the new sinus floor. The space obtained is filled with biomaterial and if necessary growth factors.
In the closed sinus lift, access is from the ridge, usually via the hole necessary for the insertion of an implant fixture. In this case there are various kits on the market, which, with different systems, make it possible to raise the membrane without lacerating it, basically working without seeing. In these cases, the advantage is the possibility of carrying out the insertion of an implant and obtaining a small increase in volume in a single surgery, with a detachment of the lower flaps, and a better post-operative phase. Usually it is recommended when the residual bone ensures a decent primary stability to the implant.
Among the parameters that the surgeon must consider when deciding to which surgery he should resort, is the anatomy of the sinus: the literature in fact recommends vestibular access to the maxillary sinuses with a very broad structure, while with narrow sinuses access from the ridge is advisable.
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