Everyone has sinus cavities located in the skull. Sinuses vary in size, with the largest being the maxillary sinuses, located behind the cheeks just above the jaw. Although the reason why people have sinuses isn’t quite understood, they seem to play a role in humidifying the air people breathe in and they might play a part in helping people speak.
A number of issues can develop in the sinuses, leading to the need for sinus surgery. For example, people can have trouble breathing if the sinuses are blocked. Some people develop regular infections in their sinuses. In some cases, the sinuses can cause an issue if a person has lost a tooth and hopes to get a dental implant.
How Tooth Loss Affects the Sinuses
In some cases, people who have lost a tooth on the upper row of teeth and are considering dental implants might have also lost a significant amount of bone. Without enough bone, it is possible for an implant to stick up into the maxillary sinus, increasing the risk for infection and discomfort.
There are a few reasons why a person might not have sufficient bone for an implant. Advanced cases of periodontal disease not only affect the gums and teeth, but can also damage the bone. Another reason for a lack of bone in the upper part of the jaw has to do with how long a person’s been missing his or her teeth. The bone supports the teeth, and without a tooth in place, it is likely that the body will reabsorb the bone, since it’s no longer doing anything.
The issue might also have something to do with a person’s anatomy. Some people have larger sinuses than others and some people have sinuses that are positioned closer to the jaw than others. In both instances, the size and position of the sinuses can make it more likely that the implant will poke through into the sinus cavity. Additionally, many people have less bone in the upper jaw naturally, even if they haven’t lost bone due to reabsorption or periodontal disease.
Sinus Surgery Before Implants
Often, periodontists and implant dentists will take preventative measures to make sure there is sufficient bone in the upper jaw to prevent or reduce the risk for any complications. A type of sinus surgery known as a sinus lift is often performed before a person gets dental implants.
A sinus lift is a type of bone grafting procedure. As its name suggests, the dentist lifts the sinus tissue away during the surgery, so that there is space for him to insert a bone graft. The bone can come from your own body, a donor or it can be synthetic. In our practice, the use of growth factors from the patient’s own plasma is routinely used in all of the sinus lifts surgeries to enhance the rate of healing as well as the end result. How much bone a dentist places in the area depends on how thick the bone is to begin with, but usually a few millimeters worth of bone is positioned in the area.
There’s usually a waiting period between a sinus lift surgery and the positioning of the implants, although a significant number of cases can be done simultaneously. The waiting period gives the grafted bone time to fully mesh with the rest of the tissue and time to become part of the jaw. Although there are often several months between the sinus lift surgery and the implant, in some cases it is possible for a person to have both at the same time. In those cases, a patient needs to have a sufficient amount of bone in the jaw to support an implant while the grafted bone fuses in place.
Sinusitis Because of Dental Implants
Patients who don’t have a sinus lift or bone graft before getting their dental implants do often have an increased risk of developing a sinus infection or sinusitis, particularly if the implant pokes through into the sinus cavity. Patients who have had a history of sinus problems and infections need to be particularly cautious about this.
If chronic sinus problems do develop after an implant is placed, a patient has a few options. A surgeon might perform endoscopic sinus surgery to clear away the sinus cavities and help them drain more easily. Dental implant repair, or in some cases removal, may also be required to reverse the infection and to remove the source of it.
In the case of a problematic implant, removing it allows the dentist to start fresh with a patient. It might be that not enough (or any) bone was grafted into place before the first implant surgery. After removing the implant, a dentist can perform a bone graft or sinus lift. Once the grafted bone is firmly in place, a new implant can be positioned, which should cause the patient fewer, if any, problems.
Preventing sinus problems is often easier than fixing them after the fact. If you’re missing a tooth on your upper row and are concerned about how placement of an implant would affect your sinuses, contact Dr. John Paul Gallardo and Dr. William P. Lamas. The two are periodontists and implant dentists in Miami, Florida. They can walk you through your options and help you decide which course of action would not only restore your smile, but provide the longest-lasting, most comfortable results. To schedule an appointment, call 305-547-8687 today.
