Sinus Lifting Bursa – Oral and Maxillofacial Surgeon Dr Ali Direnç Ulaşan

You want to have implants in the upper jaw, but after the x-ray you hear a sentence like this:

“There is upper jaw bone deficiency, we need to do a sinus lifting.”

So what exactly does upper jaw bone deficiency mean?

What kind of procedure is sinus lifting surgery?

What is the difference between open and closed sinus lifting?

Why is bone graft (bone powder) used, and what does the healing process look like before implants?

In Bursa, as oral and maxillofacial surgeon Dr Ali Direnç Ulaşan and the Milim Dental team,

we answer these questions every day for many patients who search for

“sinus lifting Bursa” and come to us for implant planning.

In this article, I will explain:

1. Upper jaw bone deficiency,
2. The difference between open and closed sinus lifting,
3. Bone graft use, implant planning and healing period,
4. And what to pay attention to after sinus lifting surgery,

in clear, patient-friendly language while staying on solid scientific ground.

1. What Is Upper Jaw Bone Deficiency?

For implants to be stable for many years,

there must be enough bone height and thickness surrounding them.

Especially in the posterior upper jaw (premolars – molars):

1. If teeth were extracted years ago,
2. If the area was left without a prosthesis for a long time,
3. If the bone was naturally thin from the beginning,
4. If the sinus cavities are anatomically large and low,

over time the following situation develops:

1. The alveolar bone (the bone that holds the teeth)
2. resorbs (shrinks) from bottom to top,
3. The maxillary sinus cavity inside the upper jaw
4. expands and sags downward,
5. As a result, the available bone height in the area where we plan to place implants
6. may drop down to only a few millimeters.

On the x-ray or 3D CT scan, your dentist may show you something like this:

“Here is your sinus cavity, and here is a very thin strip of bone.

If we place an implant into such a thin bone,

the implant might end up in the sinus space; that would not be healthy.”

In that situation,

we need to raise the sinus floor and increase bone volume before implants.

This procedure is called sinus lifting surgery.

2. What Is Sinus Lifting Surgery?

In the posterior upper jaw, above the premolars and molars,

there are air-filled spaces called the maxillary sinuses.

Sinus lifting is, simply:

Lifting the floor of the upper jaw sinus upwards

to create enough bone height for implants and

placing bone graft (bone powder) underneath.

The goals are:

1. To gently elevate the sinus membrane (Schneiderian membrane),
2. To place bone graft material under it to create
3. a new bone layer where implants can be placed,
4. To obtain a solid foundation that can carry implants for many years
5. without damaging the sinus cavity.

Sinus lifting can be performed in two main ways:

1. Closed (internal) sinus lifting
2. Open (lateral) sinus lifting

3. What Is Closed (Internal) Sinus Lifting?

Closed sinus lifting is used when we need a limited amount of bone height gain

and there is still a reasonable amount of existing bone.

3.1. Who is it suitable for?

In general, closed sinus lifting is considered when:

1. The existing bone height up to the sinus floor is around 4–6 mm,
2. A small elevation is enough to reach a safe implant length,
3. There is no severe bone loss or very large sinus expansion.

In such cases, closed sinus lifting can be a good option.

3.2. How is it done?

1. The procedure is usually done through the same site where the implant will be placed.
2. A small opening is made in the gum,
3. and the implant socket is prepared almost to its final depth.
4. With special instruments (osteotomes or similar tools),
5. the thin bone at the sinus floor and the sinus membrane on top of it
6. are gently pushed upwards in a controlled manner.
7. The new space created under the elevated membrane is filled with bone graft.
8. In many cases, the implant can be placed in the same session.

So, in closed sinus lifting,

sinus elevation and implant placement are often completed in one visit,

with a relatively small surgical intervention.

4. What Is Open (Lateral) Sinus Lifting?

Open sinus lifting (lateral window technique) is used

when the existing bone height is far more deficient and

a closed technique will not provide enough bone volume.

4.1. Who is it suitable for?

Open sinus lifting is usually preferred when:

1. The existing bone height is 2–4 mm or less,
2. The area has been edentulous (toothless) for a long time and the sinus has dropped down,
3. There were previous failed sinus procedures,
4. A wide area involving several implant sites needs augmentation.

In these cases, open (lateral) sinus lifting is often the most reliable solution.

4.2. How is it done?

1. Under local anesthesia,
2. the gum is lifted in the posterior upper jaw on the cheek side.
3. A small bony window is created in the lateral wall of the sinus.
4. Through this “window,”
5. the sinus membrane is gently elevated off the sinus floor.
6. The space created beneath the membrane is filled with bone graft material.
7. In some patients, implants can be placed in the same session;
8. in others, we first wait for bone maturation and
9. place implants in a second stage.
10. The lateral window may be covered with a membrane,
11. and the gum is sutured to complete the procedure.

Open sinus lifting

is a longer and more extensive procedure compared to the closed technique,

but in cases of severe upper jaw bone deficiency

it is one of the safest and most predictable options.

5. Why Is Bone Graft Used in Sinus Lifting?

Sinus lifting is essentially a “space-making” surgery.

When we lift the sinus membrane,

we create a space underneath that needs to be filled

so that new bone can form there.

To support and maintain this space, we use:

1. Autogenous bone (bone taken from your own body – intraoral donor sites),
2. Ready-made bone grafts (bovine-derived, synthetic, etc.),
3. Or combinations of these.

The aim is to provide:

1. A structure that your body accepts and gradually remodels into your own bone,
2. A firm foundation that can support implants
3. reliably and long-term.

In patients who come to us for sinus lifting Bursa

with upper jaw bone deficiency,

as oral and maxillofacial surgeon Dr Ali Direnç Ulaşan,

I SELECT the type of bone graft according to:

1. Your general health,
2. Your bone quality,32);">And the amount of augmentation needed.

6. Pre-Implant Planning and Digital Evaluation

Sinus lifting is not a procedure that should be done “by guesswork.”

Thorough pre-operative planning is essential.

6.1. Which examinations are needed?

1. Clinical examination
2. Missing teeth,bite/chewing pattern,opposing teeth
3. Tenderness around the sinus area,previous surgeries
4. Panoramic x-ray
5. Gives an overall idea about bone structure and sinus floor height.
6. CBCT (3D dental CT scan)
7. Exact height and thickness of the existing bone (in mm),
8. Size and shape of the sinus cavity,32);">Presence of septa (bony partitions),polyps or other sinus conditions,32);">Relationship with important structures (nerves,nasal floor,etc.)

Today,3D CBCT is considered the gold standard

for planning sinus lifting and implants in the posterior upper jaw.

6.2. Which decisions are made?

Based on these images,we decide:

1. Closed or open sinus lifting – which technique is appropriate?
2. Should we proceed in one stage or two stages?
3. In some cases,sinus lifting is done first,32);">we wait 6–9 months for bone maturation,32);">and then implants are placed.
4. In other cases,32);">sinus lifting and implant placement can be done in the same session.
5. How many implants will be placed? What will their length and diameter be?
6. What type of prosthetic plan will be used (single crowns,bridges,all-on-4/6,etc.)?

At Milim Dental,using a fully digital workflow,

we simulate your sinus lifting and implant plan on the computer

and explain the process to you with visual support before surgery.

7. Healing Time After Sinus Lifting

Healing time depends on:

1. The technique used,32);">The amount of augmentation,smoking status,and bone quality.

In general:

1. Closed sinus lifting + implant in the same session:
2. First week: normal to have swelling and mild/moderate pain
3. 7–10 days: removal of sutures
4. Around 3–4 months: osseointegration (implant–bone integration) period
5. Open sinus lifting (bone graft,implants later)First 1–2 weeks: swelling,mild bruising,soft diet
6. 10–14 days: sutures removed
7. About 6–9 months: bone maturation,then implants are placed in a second stage

In some suitable cases,

open sinus lifting and implant placement can also be done in a single session

if the existing bone height and quality allow.

This decision is made by your surgeon

after evaluating the CBCT and your individual risk factors.

8. What to Pay Attention to After Sinus Lifting Surgery

Because sinus lifting surgery involves the maxillary sinus cavitythere are some specific post-operative rules that are very important.

These rules are designed to:

1. Protect the sinus membrane,32);">Prevent sutures FROM opening,
2. Keep the bone graft stable in place,
3. Minimize the risk of infection.

8.1. Sneezing and nose blowing

This is one of the most critical points after sinus lifting.

1. Do not try to suppress sneezing,
2. but sneeze with your mouth open.
3. This way, the pressure is released through the mouth instead of the nose
4. and does not strain the sinus area.
5. Forceful nose blowing is prohibited.
6. For the first 10–14 days,
7. pulling the nose strongly or blowing the nose forcefully
8. can cause the sinus membrane to tear or sutures to open.
9. If your surgeon approves,
10. you may use nasal sprays or saline sprays
11. to keep the nasal passages clear in a gentle way.

8.2. Airplane travel and pressure changes

The sinus region is sensitive to changes in pressure.

1. If possible, avoid airplane travel in the first 10–14 days after surgery.
2. If you must fly,
3. consult your oral and maxillofacial surgeon beforehand
4. for any extra protective measures or medications.
5. In extensive/open sinus lifting with multiple implants,
6. this flight restriction may be stricter.

8.3. Smoking

Smoking:

1. Impairs blood flow,
2. Slows down healing,
3. Increases the risk of infection,
4. Decreases the chance of successful bone graft integration.

Therefore:

1. At least 1 week before the surgery, and
2. At least 2–4 weeks after sinus lifting,

you should avoid smoking as much as possible.

For advanced surgeries like implants and sinus lifting,

the ideal solution is to quit completely.

8.4. Sports, heavy lifting, bending forward

In the early days:

1. Heavy exercise,
2. Lifting heavy weights,
3. Rapid, forceful bending forward

may increase blood pressure and sinus pressure,

and raise the risk of bleeding.

Generally we recommend:

1. During the first 5–7 days, stay away from strenuous exercise,
2. Avoid heavy sports for about 2 weeks.

Light walking is usually fine and even beneficial.

8.5. Diet: What can you eat and drink?

Post-op diet aims to:

1. Avoid trauma to the surgical site,
2. Protect the sutures,
3. Support healing with adequate fluid and protein intake.

Recommendations:

1. First 24 hours:
2. Soft, not very hot foods (warm soup, yogurt, mashed dishes, purees)
3. Avoid using a straw (negative pressure in the mouth can be harmful).
4. First week:
5. Avoid hard, crunchy foods (nuts, chips, hard bread crusts).
6. Do not chew hard foods on the operated side.
7. Drink enough water to support healing.
8. Very hot beverages may increase bleeding risk in the first days,
9. so prefer warm rather than hot drinks.

8.6. Medication protocol

After sinus lifting, your oral and maxillofacial surgeon will usually prescribe:

1. Antibiotics:
2. To reduce infection risk.
3. Use them exactly as prescribed in duration and dosage.
4. Painkillers:
5. To keep you comfortable in the first 2–3 days.
6. The type of analgesic is chosen according to your general medical condition.
7. Nasal sprays / decongestants:
8. To improve sinus drainage and reduce nasal congestion,
9. used for a limited period if your doctor recommends them.
10. Sometimes, anti-edema medications may also be prescribed.

Do not stop medications early

just because you “feel fine.”

Follow the protocol determined by your surgeon.

8.7. Oral hygiene

1. For the first 24 hours, avoid vigorous mouth rinsing
2. and do not spit forcefully.
3. From the next day:
4. Brush the other teeth as usual with a soft brush,
5. but stay away from the surgery area.
6. If prescribed, use antiseptic mouthwashes (e.g., chlorhexidine)
7. for a specific time period.

A clean oral environment helps:

1. Keep the wound area clean,
2. Protect the bone graft from contamination.

9. Frequently Asked Questions About Sinus Lifting

1) Is sinus lifting a very painful surgery?

The procedure is done under local anesthesia.

You should not feel pain during surgery, only pressure or vibration.

Afterwards, mild to moderate pain and swelling for a few days is normal

and can be controlled with the prescribed painkillers.

2) Will I have permanent sinus problems after sinus lifting?

In a properly planned and correctly executed sinus lifting procedure,

sinus function is preserved.

Sinusitis or other complications are rare and,

when recognized early, can usually be managed

without permanent problems.

3) Is sinus lifting necessary for everyone who needs upper implants?

No.

Some patients have enough bone in the upper jaw,

so implants can be placed without sinus lifting.

In other patients with significant upper jaw bone deficiency,

sinus lifting may be the only realistic way

to achieve stable, fixed implant-supported teeth.

The decision is made after examination and CBCT imaging.

4) What happens if I don’t do sinus lifting?

If bone is insufficient and we try to “force” implants into too thin bone

with very short implants,

the risks of:

1. Penetration into the sinus,
2. Early implant failure,
3. Long-term implant loosening

all increase.

In some cases, the only option left may be

a removable denture (a “plate”) instead of fixed teeth.

Sinus lifting gives many patients the chance of

fixed, screw-retained teeth instead of a removable denture.

5) For sinus lifting Bursa, why should I choose an oral and maxillofacial surgeon?

Sinus lifting is an advanced surgical procedure involving:

1. The sinus cavity,
2. Delicate bone structures,
3. And complex anatomical landmarks.

As oral and maxillofacial surgeon Dr Ali Direnç Ulaşan in Bursa,

in our daily practice we perform:

1. Detailed planning with 3D CBCT,
2. Digital implant placement simulations,
3. Closed and open sinus lifting techniques when needed,
4. Same-session sinus lifting and implant placement when appropriate,
5. And careful post-operative follow-up.

This multidisciplinary, experience-based approach

increases predictability and long-term success.

10. Conclusion: Upper Jaw Bone Deficiency Is Not Hopeless

In summary:

1. Upper jaw bone deficiency does not have to end your dream of fixed implant teeth.
2. Sinus lifting surgery is a well-established, scientifically supported technique
3. that raises the sinus floor and creates new bone for implants.
4. Closed sinus lifting can be performed
5. when limited additional bone height is needed
6. and often in the same session as implant placement.
7. Open (lateral) sinus lifting is a reliable, long-term solution
8. in cases of severe bone loss and large sinus expansion.
9. After surgery, strictly following the rules on
10. sneezing, flying, smoking, sports and diet
11. is crucial to protect your sinus and bone graft.

If you:

1. Have been told “there is upper jaw bone deficiency, implants are difficult,”
2. Are searching for “sinus lifting Bursa” and feel confused by what you read,
3. Want to consult oral and maxillofacial surgeon Dr Ali Direnç Ulaşan
4. to clarify your situation,

we can create the most suitable sinus lifting and implant plan for you

after a detailed clinical examination and 3D CT scan.

With proper planning, correct surgical technique and good aftercare,

upper jaw bone deficiency is no longer a hopeless situation –

it can be the first step on your way to

stable, screw-retained fixed teeth.