What is a Sinus Intrusion?

The Consultation

Several years ago, a new patient presented for an implant consultation. The “spirit of the conversation” went something like this……..According to her, she was in desperate desire to chew again, on her right side. Her two previous dentists told her that in order for her to get the desired dental implant in the upper right side, she would need to get a full blown sinus lift procedure. She implored,” I don’t want that big surgery. The thought of it makes me cringe. My friend had it done and she was swollen for days. Can you help me?”  

My Introspective Thought

After that sincere plea for help it got me thinking about an alternative procedure being promoted at a dental seminar several months prior. I was thinking, rhetorically, can I do this for this beautiful lady? In brief, it was a minimally invasive procedure. Generally, I could potentially create sizable bone for the future implant. Lastly, there would be a minimal discomfort. After all, I wanted to help her. I had the motivation and glimmer of curiosity. In short, I said, “Let’s take a radiograph and I will see what I can do for you.”

The Lateral Wall Sinus Lift Procedure

A Lateral Wall Sinus Lift procedure is probably the most invasive procedure we execute in dentistry. Essentially, the dentist breaks into the maxillary sinus compartment with a drill, teases a thin delicate membrane off the floor of the fractured sinus and raises it, utilizing a set of specifically designed curved curettes. That’s to say, once the Synerderian membrane is gently displaced, cadaver bone is furthermore augmented to the newly created space to create a pseudo sinus floor. Subsequently, this augmented site provides the footing foundation for the future implant fixture. (I write about this in great detail in a previous blog. See “Sinus Lift” or visit my You Tube Channel Robert Emilio DDS & Associates, to witness the actual procedure live).

By the way, the implant can not be immediately placed until this new bone matures. Grafted bone needs to heal. Ordinarily, post operative swelling lasts about 3 days. Furthermore, this newly grafted bone can take up to six months to heal. Lastly, there’s a needed secondary surgery. Similarly, the implant must get inserted later on. Oh yes. Then there is an additional healing period of three months.

Evaluation & Discussion of the Cat Scan

To summarize, I said, “No problem”, with confidence. Furthermore, I continued on.”To begin with, how does it sound if I make a tiny incision and work thru a little tiny hole of 5.0 mm diameter? Next, I will then gently plunge saline water thru this little access hole to “push” the sinus membrane off the sinus floor. In short, it goes like this. Usually, one shot of local anesthetic is all that is needed. Incidentally, one small incision. So I then, push away the sinus membrane off the floor. Lastly, I will insert the bone graft and then finally, simultaneously, place the implant fixture. In short, does that sound agreeable? ” This is called a Sinus Intrusion Crestal Approach. To sum up, as I explained,” I can do it for you. I do it regularly(in my head)! Furthermore, book it today.”

Check it Out Live, If you Dare!

( You can see this procedure live on my You Tube Channel Robert Emilio DDS & Associates. Sinus Intrusion The Crestal Approach

Needless to say. She came in the other day for routine hygiene check. In conclusion, everything looked great. Likewise, see below radiographic progression

The Two Year Radiographic Follow Up

Pre Op Schematic. Tooth #3 Missing
Post Op. Fabulous Bone height achieved on Implant #3 (part of the bridge (#3-#5)

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

You Tube : Robert Emilio DDS & Associates 

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your  Friends

What’s a Sinus Lift?

A Sinus Lift is a very technical surgical procedure, that a dentist will employ to create bone capacity in the maxillary sinus for dental implant anchorage.

The maxillary sinus is essentially a hole in the maxillary aspect of your upper jaw. It is composed of several bones. The maxillary sinus reduces the skull’s weight, produces mucus which moistens our noses and affects the tone of an individual’s voice. Internally, the sinus is lined with a what is called the Schneiderian Membrane. The membrane can be tissue paper-thin or orange peel thick.

When posterior upper teeth are extracted, the superlying maxillary sinus naturally expands to occupy the former root area of the extracted teeth. This is a normal biological consequence of tooth extractions; loss of bone support and atrophy. The extraction of a tooth may seem fine when you are in dire pain, but the subsequent consequences of tooth loss are many, such as: loss of function to eat properly, significant bone loss associated with advanced aging, esthetic nightmares and the obvious social stigma of failure.

Most often people regret the extraction of their teeth and are often confronted with regaining what was. In situations of upper posterior tooth loss and significant bone loss, dental implants may be elusive, unless the Lateral Wall Sinus Lift Procedure is performed.

A dental implant must have at least 10mm of bone to have a long term success. In maxillary expansion after tooth extraction( pneumatization), the floor of the maxillary sinus can expand so much as shrink down the alveolar crestal  bone down to as  thin as 0.5 mm thick from as much as 15mm of bone height when you were a teenager. This process of pneumatization occurs very quickly over a period of several years with the greatest changes in the first 6 months after tooth loss.

My  sinus lift procedure involves,  administering local anesthetic to the upper jaw. A single long incision is made and the gum retracted away from the upper jaw. The underlying maxilla jaw is revealed upon reflection of the tissue. A small window is then created by my dental surgical drill just down to the fine membrane WITHOUT it’s perforation. A dedicated set of instrument curettes are then utilized to reflect the membrane off the inner aspect of the sinus, thus releasing and creating a relative space. Think of sticking your hand in between the pillow (sinus floor) and pillow case (membrane) and making a space. Eventually with patience, a big lift is created into which allograft ( human cadaver bone) is gently packed to create a new maxillary floor (or  new implant ceiling).  Essentially the relative dimensions of space are reformulated to create new “room” for the dental implants to be placed several months later. Once bone is  nicely  packed, I then insert a temporary collagen blanket  seal over the aforementioned window and close the flap down with many sutures. With time, everything heals and the patient’s actual bone cells replace the donated bone graft to create a unified body of gorgeous healthy viable foundation ready for dental implantation.

The patient goes home with ice to the face, pain killers, antibiotics for the week and chills with Netflix for the evening. The procedure is predictable and usually results in a substantial amount of regenerated healthy bone. It takes me about an hour and 20 minutes start to finish.

Check it Out( GRAPHIC BEWARE) !

My You Tube Channel to see Me in Action Live! performing the Lateral Wall Sinus Lift procedure on my patient.

My You Tube Channel,  Robert Emilio DDS and Associates

 

Pre-Op view Panoramic View of maxillary sinuses
Pre-Op View Cross Section of the Right Maxillary Sinus via CBCT
Post Op Panoramic View of Sinus Bone Augmentation of Right Maxillary Sinus

Dr. Emilio & Associates,  Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients’ Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  blog@robertemiliodds.com

Instagram:  dentist_in_connecticut

Office (203)866-7164      www.robertemiliodds.com

Pass this Link to Your Friends:  robertemilioddsblog.wordpress.com