After loosing a tooth in the upper jaw (maxilla), bone loss usually occurs as it does in the lower jaw (mandible). However, directly above the maxilla is the maxillary sinus. This anatomical structure can cause problems if you are trying to replace missing teeth with dental implants. It is traditional thought that 10 mm of vertical bone height is needed to support a dental implant. If there is not 10 mm then some surgical modification will need to be made.
If there is less than 5 mm of vertical bone, then the traditional lateral approach sinus lift is utilized. This is where you go through the maxilla on the side to raise the sinus and add bone. Usually you will allow 6 months of healing before the implants are added. In really severe cases of bone loss, a sinus lift is preformed and blocks of bone are added (as seen in the photo).
If there is 5 mm or greater of bone, then there may be options. Sometimes, a lateral approach can be preformed and the implants placed at the same time. Another approach is the transcrestal sinus lift. This is where you drill through the maxilla in a vertical direction but stop short of the sinus. At that point you use an instrument to fracture the remaining bone and push it upward. This allows for the sinus to be raised 1 to 5 mm. This procedure can be done by itself or at the same time as dental implant placement.
The final option may be to use shorter dental options. However, there are limitations to there use.
When considering maxillary dental implants, discuss all your options with your dental implant surgeon. Call Dr. John Freeman today for a consult.