The jawbone which is a cavity the size of a ping pong ball, has a tendency to grow larger with age. When the extractions are practiced on the higher and back teeth, it often occurs that the cast of the alveolus which follows the extraction is accompanied by an expansion of the sinus around the area of the teeth. In fact, it is as if the pressure of the air in the sinus during breathing was due to the residual bone of the extraction.
The bone not stimulated is empty of its tooth and lets penetrate progressively the sinus jawbone, which increases in size.
We find at this juncture a clinical situation which is often the same: The implantation is impossible because the quantity of bone is reduced to less than 4mm.
The choice is then the graft or the denture ?
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How to perform the graft ?
Like all surgical bone techniques, the intervention is performed under anesthesia (local) with a premedication sedative, in our operating rooms.
A flap permits access to a bone flap approximately 2x1cm. This flap will be pushed back to the interior of the sinus and the Schneider membrane will recede at the same time, leaving an opening around 4cc.
This opening can receive:
Your bones (taken elsewhere)
A filling material
A mixture of the two
After 4 / 6 months (depending on the type of material used) the position of the implants becomes possible in a bone not yet mature, but sufficiently consistent to assure its primary stability. It is necessary to wait another 6 months for the graft and the implants to be sufficiently resistant to receive your new teeth.
The intervention, is it painful ?
As a general rule this intervention is not painful, but when the anesthetic finishes, it is necessary to take painkillers and anti inflammatory drugs because we canot make an omelet without breaking the eggs !
The post operatory pain is not very important, but it exists.
Swelling may also occur underneath the eye, and an orbital hematoma may persist for a few days.
These symptoms are not a bad omen for the scaring; on the contrary they are good signs.
Am I going to bleed ?
The blood is a necessary element to the formation of intra-sinus clots, which permits the augmentation of the bones volume.
The bleeding is always very limited and well controlled during the intervention. It is preferable to have a small amount of bleeding, rather than no bleeding at all.
It is always necessary to interrupt an anticoagulant treatment or the taking of aspirin one week before the intervention.
What are the risks of the intervention ?
If you are in good health (medical questionnaire is obligatory), the only real risk encountered is the failure of the graft. Even if these failures are rare, they can arrive from the following :
Infection of the graft due to germs
Repeated sniffing caused by the flu
A very tired patient, immune system deprived with a weak potential to repair
Tearing of the membrane with loss of graft by the nasal track
In all cases, everything falls rapidly in order, but it is back to square one. It is always possible to retry after 4 months.
What precautions should I take ?
BEFORE :
Rinse your mouth
Take antibiotics
Do not get sick with the flu
Do not take aspirin
Do not be tired
Avoid contact with sick people
Stop smoking
AFTER : ditto, more
Do not blow your nose
Sneeze with your mouth open
Do not go diving under water during the period of scaring (6 months)
Do not take an airplane for 1 month
Clean your nose with salt water spray
Rest the entire day and retake your activities without excess for a period of one week
