The sinus expands when teeth disappear.
The maxillary sinus is a paired, air-filled cavity sitting above the upper back teeth. In a fully dentate adult, the bone under the sinus is usually adequate to support upper back teeth and, if needed, implants. After upper back teeth are lost, two processes work against that bone simultaneously: the alveolar bone resorbs from above, and the sinus floor tends to descend over time. The net result, often within a few years of tooth loss, is that the remaining bone height is too thin to seat an implant of standard length.
A sinus lift solves the problem by gently elevating the sinus floor membrane and placing graft material in the space created. Over the integration period, that graft consolidates into bone. An implant can then be placed at adequate length and stability.
Sinus lift is one of the most routinely performed procedures in implant dentistry, with well-established techniques and outcomes. It is also one of the most commonly over-prescribed when other paths, strategic implant angulation, shorter implants in the right anatomy, or zygomatic surgery for severe cases, would serve the patient better. We’ll be honest about which fits.
Two techniques, one principle.
Direct (crestal) sinus lift
The sinus floor is accessed through the same osteotomy as the implant. The membrane is gently elevated upward, typically 3–4 mm, using specialized osteotomes or hydraulic technique. Graft material is placed and the implant seated in the same procedure. Minimally invasive, fast healing, and the only realistic option for limited augmentations.
Suitable when: 4 mm or more of native bone height remains under the sinus, and only a few millimeters of additional height are needed.
Lateral window sinus lift
A small bony window is created on the side of the upper jaw, providing direct visual access to the sinus membrane. The membrane is carefully lifted across a wider area and a larger volume of graft material is placed. Implants may be placed simultaneously (if primary stability is achievable) or staged after graft maturation.
Suitable when: significant bone height needs to be added, 5 mm or more, or when the defect anatomy makes a direct approach impractical. More involved, longer recovery, but predictable and widely used.
The choice between direct and lateral is made from the CBCT at the planning appointment. Many cases are clearly one or the other; some sit on the boundary, in which case the surgical decision is made intraoperatively after evaluating membrane behaviour.
Same surgery or separate phases?
Combined. Sinus lift performed at the same time as implant placement. Preferred when residual bone height provides adequate implant stability (typically 4 mm or more). The graft and implant heal together over 4–6 months. Total treatment time is shorter and there’s only one surgical day.
Staged. Sinus lift first, healing for 6–9 months, then implant placement as a separate procedure. Used when native bone height is too low to anchor the implant stably at the same surgical day. The trade-off is two surgical days instead of one, in exchange for a more predictable implant outcome in cases where combined wouldn’t be reliable.
We confirm which approach fits at the planning appointment, from the CBCT. Most patients prefer combined where possible; staging is the right call when the bone picture demands it. See bone grafting for the broader grafting context.
What to expect. And what to avoid.
First 72 hours. Pressure and fullness in the cheek and upper jaw area. Mild swelling, sometimes mild bruising. A small amount of bloody drainage from the nostril on the surgical side is normal and expected within the first 24–48 hours. Pain is typically manageable with over-the-counter medication; prescription medication is provided where indicated.
First two weeks. Most patients return to normal daily activity within a few days. The instructions you’ll need to follow are conservative and non-negotiable while the graft is healing:
- No nose-blowing (sneeze with mouth open if you have to sneeze)
- No drinking through a straw
- No smoking: at all, for the healing window
- No air travel for the period we specify
- No swimming or scuba
- Soft diet, avoid pressure on the surgical area
These restrictions exist because pressure changes can disturb the elevated sinus membrane or the freshly placed graft. They’re temporary; they meaningfully reduce the chance of complication.
Long-term. Sinus lifts have well-published success rates above 95% when performed by an experienced surgeon. Complications, membrane perforation, graft loss, sinus infection, are uncommon and managed when they occur.
When sinus lift isn’t the right answer.
For severe maxillary atrophy, where even an aggressive sinus lift wouldn’t create enough reliable bone for conventional implants, zygomatic implants are usually the cleaner path. They bypass the upper-jaw bone entirely by anchoring into the cheekbone, and they often deliver fixed teeth in a fraction of the time staged grafting would require.
The honest comparison is made with the CBCT in front of us. Book a consultation and we’ll walk through every realistic option for your case: sinus lift, zygomatic, or one of the implant configurations that avoid the sinus altogether (see All-on-4).