One of our specialties at DC Perio & Implants is our focus on replacement of teeth and dental implants. A dental im-plant is a high-tech replacement of the roots that provide a permanent foundation for fixed replaced of teeth. Due to their effective long-term solution for patients who suffer from missing or failing teeth or chronic periodontal dis-ease dental implants have become a popular solution as compared to dentures, bridges and crowns. Additionally, due to their natural look, long-lasting, reliability, high success rate and improved ability to eat and chew as well as improved facial and bone features dental implants have become the standard of care at DC Perio & Implants in tooth replacement. Dental implants are made out of titanium (we also offer metal free dental implants at DC Perio & Implants) that over time actually fuses to the living bone cells of the jaw and becomes part of the jaw bone. This intimate and tight connection creased a durable and strong anchor for the new teeth. This allows the ability to eat and chew that is not different as compared to natural teeth.

When is a Sinus Lift Required:

It is not always easy to achieve strong and healthy dental implants, but when necessary, a sinus lift procedure, also known as sinus augmentation is definitely a step on the road to a full and healthy smile. This relatively common procedure makes it possible to enjoy the full benefits of dental implants, even after significant bone loss. At DC Perio & Implants we will break down each step of the sinus lift procedure, recovery, risks, and commonly asked questions to give you all the information you need to know. A sinus lift, also called sinus augmentation, is a procedure that makes it easier to place dental implants. Some patients need dental implants but have suffered bone loss, thus not having sufficient bone support necessary for implants. You can get the support you need by having a sinus augmentation. This procedure increases the amount of bone in the upper back jaw that is required for dental implants. This is one of the most common bone grafting procedures for dental implant patients. Often times, sinus augmentations are one of the many procedures done during a full mouth reconstruction. Whereas a dental bridge may on average only last around 10 years, dental implants can last a lifetime. The implant is made from titanium and integrates with the jawbone. It is bio-compatible, meaning that it is non-toxic and not rejected by the body. Dental implants make a powerful re-placement teeth. As more research and evidence is gathered we should be able to make the statements that dental implants last a lifetime. However, at this time we “only” have 30 – 35 years of evidence and data to rely on. Dental implants have a come a long way from their infancy in the 1960-1980s. As technology, surface topography and growth factors are further studied we expect innovation and changes to the filed of dental implantology.

Who Needs A Sinus Augmentation?

Over the last 30 years, dental implants have become more readily available, making them an increasingly common dental procedure. As more people get dental implants to replace missing teeth, sinus lifts also have become more common. A sinus augmentation may be necessary if you are missing teeth and jawbone in the back of your upper jaw, near your sinuses. Jawbone and teeth in this area could be lost due to birth defects, periodontal disease, cancer, other medical conditions, expanding sinus or just the natural healing process. A sinus lift can also be used if your sinuses are too close to your upper jaw and you need more space to place the implant.

What Happens Before a Sinus Augmentation Procedure?

A sinus lift is basically a bone transplant. You’re using a bone from one place and using it in your upper jaw. The first step is to determine where the bone used in the surgery will come from. The three most common types of bone used at DC Perio & Implants in sinus lift surgeries are:

• Bone from your own body (autogenous bone) usually taken from other areas of your mouth or body.
• Bone from a cadaver (allogenic bone)
• Bone from a cow (xenograft)
• A synthetic bone-like material

After the bone source is identified, your surgeon will take great care to study the anatomy of your jaw and sinus. Ac-curate measurements will be taken to evaluate the height and width of your existing bone and to evaluate your sinus. Once the doctor and you have chosen the bone to use, they will move forward with the procedure.

What Happens During the Sinus Augmentation Procedure?

The sinus lift procedure is a safe and straightforward procedure. A sinus augmentation is generally performed at the periodontal practice. The entire process takes between 60 – 90 minutes.

1. First, the patient is sedated using local and/or intravenous sedation. If necessary, a doctor may use nitrous ox-ide as well.
2. Next, the surgeon will push the gum tissue where your back teeth used to be to expose the jawbone.
3. With the tissue raised, and the jawbone exposed, the surgeon will cut a small circle in the bone through which they can gently push on the membrane of the sinuses.
4. As the bony piece is lifted into the sinus cavity space the hole is filled with the previously determined bone graft.
5. After this is done, the procedure is complete and the surgeon will close the incision with sutures.

What Happens After a Sinus Augmentation?

At DC Perio & Implants patients are able to go home after they wake from the anesthesia. After the sinus lift procedure, most patients experience a little swelling and bleeding, but only minimal discomfort. The most important part of recovery is to keep the bone graft in place, so it’s important to avoid blowing your nose (or sneezing, if possible) Either of these things could cause the bone-graft material to move and loosen the stitches. At DC Perio & Implants we make sure that you go home with thorough and detailed post op instructions. We will also give you a prescription to prevent congestion and swelling, a prescription for pain medicine, an antibiotic, and/or an antimicrobial mouthwash to help prevent infection. At DC Perio & Implants we will follow up with you in fourteen days after the sinus augmentation procedure. During this appointment, your periodontist will examine the surgical site and may remove any stitches that have not dissolved on their own. In some cases, patients are asked to return a few more times just to make sure the area is healing properly and to take necessary x-ray images. A full recovery from a sinus lift takes a minimum of 3-4 months for the sinuses to heal and the bone to be strong enough to support dental implants. Although the process may seem slow, you are working towards results that will last a lifetime. At DC Perio & Implants we often also place the dental im-plants at the same time as sinus augmentation. An ap-proach referred to as immediate implant placement.

Risks of a Sinus Augmentation Procedure

A sinus lift is a surgical procedure and therefore carries some inherent risks. The main risk of this surgery is the piercing or tearing of the membrane. If this happens, it can be repaired and the surgery can continue. Sometimes, in the case of a larger tear, the membrane would need to be given time to heal before the lift can take place again later. The bigger risk is a sinus infection. Your surgeon will give you medication to protect against this and you should be careful not to sneeze or blow your nose too heavily to avoid moving the bone graft material or dislodge your stitches. For this reason, we don’t recommend getting a sinus augmentation during your allergy season.

Making the Impossible, Possible Again

While sinus lift surgery might seem like a major undertaking, those who have gone through it report the benefits are completely worth it. To have dental implants put into place, you must have a supportive base. For many patients, the only way of achieving this adequate support system is with a sinus augmentation procedure. This effective surgery is the answer to patients that don’t have any other means to support their dental implants. With a sinus augmentation, you can enjoy all the benefits of natural, strong, and beautiful teeth – even if you have missing or failing jaw bones. Our surgical team at DC Perio & Implants will walk you through every step to give you the smile you’ve always wanted.

Who Are candidates for Dental Implants?

Majority of people and overwhelmingly high number of patients are good candidates for dental implants. At DC Perio & Implants in Washington, DC dental implants can be used to replace missing teeth in place of bridges or dentures. Ideal candidate have healthy gums and sufficient bone for placement of dental implants. In contrast to common belief advanced age is not a contraindication and understandably most dental implants are placed in individuals 50 years of age or older. Even if you have lost bone in your jaw bone you may still have sufficient enough of bone for dental implants to be placed. Furthermore, placement of dental implants can prevent further bone loss as the placement of dental implants will provide the jaw bone with a purpose and function. At DC Perio & Implants we put a heavy emphasis at prop-er evaluation and sequence of the treatment. Proper evaluation and successful implantation starts with a thorough evaluation of your jaw, teeth, mouth and overall health. At DC Perio and Implants a three dimensional x-ray (called Cone Beam CT-Scan) is taken. This detailed x-ray will aid us to identify areas of bone loss and carefully see the shape of your sinuses and nerve location to make accurate assessments for your dental implant placement. At DC Perio & Implants we will also do a thorough medical evaluation, as your overall health and history plays a big role in how well the dental implants will heal and fuse to the bone. Some of the medical histories to be concerned with include uncontrolled diabetes, cancer, radiation to the jaws, smoking, alcoholism, or uncontrolled gum disease that put the patient at an increased risk for an adverse outcome or a failed dental implant. Patients may still be a good candidate with one of these diseases, but we’ll want to thoroughly assess your situation and work with our patients and their physicians to increase their overall health and functioning. Overall, at DC Perio & Implants we highly believe in dental implants to improve our patients’ quality of care as they have a very high rate of success and patients tell us how happy they are with the outcome. If you are considering implants, we can complete a careful examination to determine what options are best suited for you. Call us today at (202) 659-3500 to make that appointment!

Armin Abron, DDS, MS