Sinus lift in Astana: types, indications, and how the surgery is performed

Anatomy of the upper jaw and sinus

The upper jaw is structured differently from the lower jaw. Above the roots of the posterior teeth lies the maxillary sinus, an air-filled cavity lined with mucous membrane. In some people, a thick layer of bone remains between the sinus floor and the oral cavity. In others, it is thin, sometimes only a couple of millimeters. If the teeth in this area have been missing for a long time, the bone gradually resorbs: the load is gone, and volume is lost. The implant screw must be placed in dense bone and must not enter the sinus. When there is insufficient height, placement is impossible without preparation. The procedure lifts the sinus lining and fills the resulting space with bone graft material. After a few months, new bone forms in this area, providing support for the implant. The cost of the procedure depends on its extent and the materials chosen, but the doctor determines the price after examination and imaging. This procedure is used specifically in cases where implantation in the posterior region cannot be performed without it.

Goals of surgery for insufficient bone tissue

Bone graft material and membrane: what is used

Access and course of the procedure

Amount of lift and quantity of material

The closed technique allows the floor of the maxillary sinus to be lifted by a small amount—usually enough to place a single implant in the site of a recently extracted tooth. Little material is used, and sometimes it is replaced by a blood clot from the socket itself. The open technique provides access to a wide area of the sinus floor, so it can be lifted higher and over a greater extent. More bone graft material is placed, and it is covered on top with a barrier membrane. The height of the lift is not chosen "by eye": it is determined from imaging, based on how much native bone remains under the sinus and which implant is planned. If there is little native bone, the closed option will not provide the needed volume, and the decision is made in favor of the open technique. The cost of the procedure depends on the chosen method, the amount of material, and the number of implants—these parameters are calculated together, not separately.

When each technique is chosen

Severe bone atrophy

The height of bone under the maxillary sinus varies from person to person. After tooth extraction, it decreases, and sometimes only a couple of millimeters remain. Then there is simply nowhere to place the screw. The closed technique lifts the sinus floor by a millimeter or two, which is sufficient only for a small deficiency. When the bone reserve is exhausted, open access is needed: a window in the anterior wall of the sinus, elevation of the lining, and introduction of bone material. The volume and shape of the future ridge are planned in advance. The doctor reviews the imaging and decides whether there is enough bone for stable implant placement. If not, the open approach gives the surgeon visibility and room to work. Closed sinus lift is not suitable in such a situation: lifting the lining high while working blind is risky, and it can easily tear. This also explains the difference in price: open access requires more materials and time. The decision depends on the clinical picture, not on the patient's wishes.

Situations with multiple implants

What the doctor evaluates before choosing a method

Timeline for soft tissue healing

The mucous membrane heals first. Sutures are removed when the wound edges have closed, usually after 10–14 days, but with thin gums or tension the timing shifts. Swelling subsides within a few days, and a small hematoma resolves on its own. Complete mucosal healing takes about a month. At this stage the patient no longer feels discomfort, but remodeling continues underneath. Open and closed sinus lifts differ in access, so the wound surface area varies. With the closed protocol the incision is smaller and soft tissues recover faster. With the open approach the access is wider and healing is slower, but that does not mean the method is worse: the clinical picture dictates the choice. Closed sinus lift, which costs less, is not always suitable — the doctor decides based on imaging. Even if the soft tissues have healed, that does not yet mean the bone is ready for loading.

Stages of bone maturation

Factors affecting timing

Examination and imaging before surgery

What to discuss with the doctor in advance

The conversation before surgery is no less important than the imaging. It is worth honestly listing all medications taken regularly, including blood pressure drugs, hormonal medications, and blood thinners. The doctor decides what to stop, what to continue, and for how long. Allergies to antibiotics and anesthetics, previous surgeries, and chronic conditions are discussed separately. If the person smokes, that should also be stated directly: smoking affects tissue healing, and the doctor may suggest reducing the number of cigarettes before and after the procedure. They also discuss how the operation itself will go: what access is planned, how long it will take, whether sedation will be used or local anesthesia is sufficient. They clarify which sensations are considered normal in the first days and which ones require contacting the clinic. Here they also ask questions about how the procedure combines with implant placement in a specific case and how long each stage will take. It is best to write down the plan or ask for a printout. That way there is less confusion on the day of surgery.

Restrictions before and on the day of surgery

Difference between the methods

Sinus lift and bone grafting solve different problems. The first lifts the floor of the maxillary sinus and creates volume above the implant. The second replaces bone deficiency in any part of the jaw — in the lower jaw, in the posterior regions, in the area of a removed tooth. If the bone height under the sinus is low but the rest of the ridge is dense, lifting the floor is enough. When the loss extends more widely — in width, along the length of the ridge — one procedure is not enough. Grafting material is introduced in different forms: granules, blocks, membranes. The surgeon determines the choice of carrier and access. There is no replacement as such: the procedures complement each other rather than compete. Sometimes sinus floor elevation is performed separately, and that is sufficient. In other cases it becomes part of a larger reconstruction. The clinical picture decides, not the desire to reduce the number of stages.

When a combination of procedures is needed

What the doctor determines from imaging

Planning begins with a CT scan. The images show the height and width of the bone, the thickness of the sinus walls, and the condition of the septa. The doctor measures how many millimeters are missing to reach the required volume. If the deficiency is only in height and is moderate, a sinus floor elevation is sufficient. When the scan shows a loss in width or an extensive cavity, the plan is expanded to include bone grafting. Bone density is assessed separately: a porous structure holds the implant less effectively, and this changes the approach. The adjacent teeth, the bite, and the condition of the sinus mucosa are also examined. Chronic inflammation in the sinus is a reason to treat it first. Based on the examination and CT findings, the surgeon proposes one option or a combination. The patient receives an explanation of why this particular approach was chosen. The final decision is made together, taking into account the overall health and willingness to undergo several stages.

The Impact of Smoking on Healing

The vasoconstrictive effect of nicotine reduces blood flow to the tissues. In the surgical area, this slows down clot formation and flap nourishment. The mucous membrane in smokers is thinner and drier, and local immunity works weaker. Vascular spasm lasts not minutes but hours after each cigarette. Therefore, swelling and discomfort may persist longer than usual. This leads to risks: suture dehiscence, membrane exposure, wound infection. It is worth mentioning closed sinus lift separately — with this approach, the tissues are already under stress, and smoking adds hypoxia to them. Bone healing also depends on blood supply. Where there is no stable nourishment, new tissue forms more slowly and less densely. No one can say in advance exactly how long recovery will take: it depends on the clinical picture, smoking history, and number of cigarettes per day. The doctor assesses the condition of the mucous membrane, bone thickness, and blood flow quality based on examination and imaging data. If the patient has smoked heavily and for a long time, the surgeon may suggest a different plan or postpone the procedure.

Recommendations for quitting cigarettes

What the doctor considers when planning

During the consultation, the surgeon clarifies the smoking history, number of cigarettes per day, and how long ago the last one was. These data influence the choice of approach: with pronounced tissue deficiency, the open method provides more control but also requires stricter conditions. The condition of the mucous membrane, thickness of the bone floor, and width of the sinus are assessed on imaging. They also check separately whether there are signs of inflammation in the oral cavity and nasopharynx. If the patient smokes, the doctor may order additional tests or refer to a physician. Sometimes the surgery is postponed to a period when the person is ready to quit cigarettes. Postoperative restrictions are also included in the plan: rest, hygiene, and smoking cessation for a period determined individually. Managing such patients requires more frequent follow-up examinations. This is not a guarantee of results but a way to notice a problem in time. The timing and extent of the intervention are individual in each case; there is no universal protocol for smokers.

Key takeaways

Open access is needed when there is too little bone under the sinus for a stable screw. The doctor lifts the mucous membrane and places the material. This is not a separate service, but part of preparation for implantation. The closed method is simpler, but is suitable for a small volume deficit. The choice is made by the surgeon based on the scans, not on the patient's wishes. The bone heals for months, and this cannot be accelerated. Smoking, chronic diseases and poor hygiene slow down the process. Sometimes instead of a sinus lift, an alternative is offered — short implants or bone grafting in another area. The doctor decides based on the clinical picture. The operation itself does not guarantee that the implant will take: the outcome depends on the condition of the bone, the load and care. If after the intervention there is swelling, nosebleeds or pain that does not subside, an examination is needed, not waiting. Follow-up scans show how the bone is forming; without them, the result cannot be assessed. You can book an appointment when you have questions, but the method is chosen after diagnostics.

Questions worth asking the doctor

Ask which approach is planned and why. Ask them to show you on the scan exactly where the bone is lacking. Clarify which material is used and how it will behave over time. Ask how long to wait before implant placement and what this timeframe depends on. Find out what to do in case of swelling, pain or nosebleeds. Ask how smoking will affect healing in your specific case. Clarify whether follow-up scans are needed and when. Ask what alternatives exist if a sinus lift is not suitable. Clarify how to care for the oral cavity during the healing period. Ask which symptoms require an unscheduled visit. The answers will help you understand the plan and reduce anxiety. If anything remains unclear, ask again before the operation, not after.