Sinus lift with dental implants in Medellín: when the upper jaw changes the plan
Implants for upper back teeth sometimes need more bone than the jaw has left beneath the sinus. Here is what a sinus lift is, how the two main approaches differ, what the research shows, and how it reshapes a Medellín trip.
The roots of the upper premolars and molars sit just beneath the maxillary sinus, the air space behind your cheekbones. After those teeth are lost, the bone below the sinus can thin from both directions. When there is not enough height left for the planned implant, a surgeon may suggest a sinus lift, also called sinus floor elevation.
What a sinus lift actually does
The sinus is lined by a thin membrane. In a sinus lift, the surgeon gently raises that membrane from the bone floor and places graft material in the space created. Over time, that material is meant to become part of the bone that supports the implant. Nothing is done to the sinus beyond its floor, and when it works the sinus continues to function normally.
It is a site-development procedure, not a separate treatment. It exists to make room for an implant where the plan needs one.
How the need is measured
The decision comes from 3D imaging, not a panoramic X-ray. A CBCT shows the height and width of bone under the sinus, the shape of the sinus floor and any existing sinus problems. Our guide to CBCT scans for implants explains what the scan shows, and what a CBCT decides about grafting covers how surgeons read it.
The numbers matter less than the plan they support. How much bone is enough depends on the implant length and design the surgeon wants, the tooth being replaced and the forces it will carry. Ask the surgeon to show you, on your scan, how much bone there is now and how much the plan needs.
Two main approaches
Crestal (internal) approach
The surgeon works through the same small opening prepared for the implant, tapping or lifting the sinus floor upward from below. It suits cases with a moderate shortfall, where only a small lift is needed. It is less invasive, and the implant is often placed at the same visit.
Lateral window approach
The surgeon makes a small window in the side wall of the upper jaw, above the back teeth, lifts the membrane directly and packs graft material underneath. It is used when more height is needed. Depending on how much bone remains, the implant may go in at the same surgery or months later, once the graft has matured.
What the research shows
A systematic review in the Journal of Clinical Periodontology pooled studies of implants placed with sinus floor elevation. It reported an estimated three-year implant survival of 90.1% overall, rising to 98.3% with rough-surface implants and a membrane covering the lateral window, and described surgical complications as infrequent. It also found that, measured per patient rather than per implant, an estimated 16.6% of patients lost at least one implant within three years (Journal of Clinical Periodontology, 2008).
Two cautions apply. The review is from 2008, and materials and techniques have developed since. And the per-patient figure is a reminder that survival statistics quoted per implant can sound better than the chance that you personally have a problem. Ask the clinic what technique and materials they use and how they follow up sinus cases.
Risks worth discussing
Among the risks of implant placement, the FDA names perforation of the sinus (FDA, 2021). In a sinus lift, the membrane is handled on purpose, so the questions are how the surgeon reduces the risk of a tear and what they do if one happens. Ask:
- What happens if the membrane tears during surgery?
- Would that mean stopping, repairing it or delaying the implant?
- Do I have any sinus history, such as chronic sinusitis or past sinus surgery, that changes your plan?
- What symptoms after surgery should make me call you straight away?
Simultaneous or staged, and what it does to the trip
| Scenario | Typical sequence | Effect on the Medellín plan |
|---|---|---|
| Small crestal lift | Lift and implant together | Often fits within the normal implant surgery trip |
| Lateral lift with implant at the same time | One surgery, longer healing before the crown | Same number of surgical trips; possibly a longer wait before the crown |
| Lateral lift, implant later | Graft first, implant after healing | Usually adds a surgical stage, and often a trip |
| Lift within a full-arch plan | Depends on the overall design | May rule out same-day fixed teeth on that arch |
That last row comes from consensus guidance. The International Team for Implantology lists simultaneous sinus floor elevation as a relative contraindication to immediate loading of a full-arch fixed bridge (ITI Consensus Conference, 2013). If you have been promised same-day teeth and a sinus lift on the same arch, ask how both fit together.
A remote CBCT review can suggest which scenario applies, but the final decision is often made during surgery. If the surgeon cannot get the implant stable enough, a planned simultaneous case may become staged. Ask for that possibility, and its cost, to be written into the plan.
Been told you need a sinus lift?
Send the CBCT as DICOM files along with the plan. We can help you understand what the proposal seems to involve, whether it assumes one surgery or two, and which questions to ask before you commit.
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Recovery from a sinus lift usually comes with rules about nose-blowing, sneezing and pressure that ordinary implant aftercare does not. Those rules also affect when you can fly. Our article on flying after implant surgery sets out what to ask about cabin pressure and the sinus. Choose lodging close to the clinic so a check-up is easy if the surgeon wants one before you leave.
What to tell the surgeon beforehand
Some details only you can supply, and they matter more for sinus work than for a lower-jaw implant:
- Any history of sinus infections, nasal polyps, sinus surgery or facial injury
- Allergies that leave you congested for long periods
- Whether you smoke or vape, and how much
- Any plans to fly, dive or travel to high altitude soon after surgery
- Previous tooth extractions in that area and whether anything unusual happened
If you have seen an ENT doctor, bring their notes or a short summary.
How the timeline to the crown shifts
A sinus lift mostly adds time between the implant going in and the crown going on. With a small crestal lift, that may be similar to an ordinary implant. With a lateral graft, the surgeon usually wants the new bone to mature before the implant takes the load of chewing, and if the implant is placed later, that is a second healing period on top of the first. Ask the clinic to give the dates as a sequence: graft, implant, check, final crown. Then see which visits have to be in Medellín.
When two clinics disagree
It is common for one clinic to recommend a sinus lift and another to propose a plan without one, such as a shorter implant, a different angle or a different tooth position. Neither is automatically right. Ask each clinic to show you on the same CBCT:
- How much bone they measure under the sinus
- Which implant length and position they plan, and why
- What the alternative would be and why they rejected it
- How their plan changes the number of surgeries and trips
A cheaper plan without a lift is only better if it is sound. A plan with a lift is only better if the lift is actually needed. The explanations will tell you more than the prices.
What to compare in a sinus-lift quote
- Which approach, crestal or lateral
- Graft material and any membrane, listed separately
- Whether the implant is placed at the same time
- Imaging before and after
- Follow-up visits and who provides them
- What is charged if the plan changes from simultaneous to staged
For broader context on grafting and the trip, see our bone grafting guide.
Frequently asked questions
Will I feel the graft inside my nose or sinus?
Most people do not feel the graft itself once it has healed. In the early days some pressure, congestion or slight nosebleeds can occur. Ask the surgeon which symptoms are expected and which are not.
I have chronic sinusitis. Can I still have a sinus lift?
Possibly, but it needs to be discussed before surgery. Active sinus problems may need assessment or treatment first. Tell the clinic about any sinus history and bring records from an ENT doctor if you have them.
Does a sinus lift make implant failure more likely?
The 2008 review found high survival overall, especially with rough-surface implants and a covered lateral window, but survival per patient was lower than per implant. Your own risk depends on bone, health, technique and habits such as smoking.
What graft material will be used?
Options include your own bone, processed donor bone, animal-derived bone and synthetic materials. Ask which one the surgeon plans, why, and whether it is itemized in the quote.
Is a sinus lift more painful than an ordinary implant?
A crestal lift is often similar to a standard implant. A lateral window procedure is a larger surgery and usually means more swelling. Ask the clinic what recovery to plan for with the approach they propose.