Sinus lift and bone grafts before dental implants

A sinus lift is surgery that adds bone to the upper jaw, under the sinus, so there's enough height to hold a dental implant. A bone graft does the same job wherever the jaw is too thin or too short. You might need one before implants if you've lost bone after losing a tooth or through gum disease. The grafted bone usually needs 4 to 12 months to develop before the implant goes in, although sometimes both happen in one operation. After a sinus lift, don't blow your nose for two weeks, and wait at least two weeks before you fly.

This guide explains why grafts are needed, how the procedures work, how long healing takes, the risks, and how a graft changes your plans for treatment in Vietnam.

Why some people need more bone

An implant needs enough bone around it to stay stable. The American Academy of Periodontology (AAP) says bone loss from gum disease or tooth loss can leave too little bone in the upper back jaw, and calls it one of the most difficult areas for implants. The sinuses sit just above the roots of the upper back teeth, so there may be only a thin layer of bone left.

Elsewhere in the mouth, the AAP says deformities in the jaw can leave too little bone for implants. It lists gum disease, wearing dentures, developmental defects and injury as causes.

The surgeon finds this out from a 3D CBCT scan. That's why clinics ask for a scan, or take one, before they can confirm an implant plan. Our guide to dental X-rays and CBCT scans explains which images to send before you travel.

Types of procedure

Procedure	What it does	Implant at the same time?
Sinus lift, external (lateral) approach, very little bone	Graft added from the cheek side to raise the sinus membrane	Usually no; the implant goes in once the bone has healed
Sinus lift, external approach, some bone	Same approach	Often yes
Sinus lift, internal approach, some bone	Sinus floor gently tapped up through the implant site	Usually yes, in the same visit
Ridge modification (augmentation)	Gum lifted and the gap filled with bone or a bone substitute to build up the jaw	Sometimes

The three sinus lift types come from a Cambridge University Hospitals NHS leaflet. The ridge modification description comes from the AAP.

How a sinus lift is done

The AAP describes the external approach. The surgeon makes a cut in the gum to expose the bone, cuts a small circle in the bone, and lifts it into the sinus space "much like a trap door". The space underneath is filled with bone graft material, and the gum is closed.

The Cambridge leaflet says the surgery is normally done under local anaesthetic as an outpatient, isn't normally painful during the operation, and takes about 45 minutes to two hours. Stitches are usually taken out about a week later.

For a ridge augmentation, the AAP says the gum is lifted away from the ridge and the gap is filled with bone or a bone substitute before the gum is closed. Your surgeon can explain which graft material they plan to use and why.

How long healing takes

Source	Healing time
American Academy of Periodontology (sinus lift and ridge modification)	Bone usually given 4 to 12 months before implants are placed
Cambridge University Hospitals NHS leaflet (external sinus lift)	About 4 to 9 months for the graft to join with your own bone
Same leaflet, whole treatment	Typically 6 to 12 months from the sinus lift to the final teeth, and it can be longer

After the implant goes in, the bone needs more time to grow onto it before the final crown. Our guide to dental implant healing stages explains that stage.

Aftercare

The Cambridge leaflet gives this advice after a sinus lift:

• Don't blow your nose for two weeks.
• Use menthol steam inhalations three times a day for ten days.
• Take painkillers, and any antibiotics or decongestants you're prescribed.
• Go back about a week later to have stitches removed.

It also notes that smoking raises the risk of the graft failing. If you smoke, ask your surgeon how this affects your plan.

Risks

The Cambridge leaflet lists these risks:

When	What can happen
Common, early	A tear in the sinus membrane, swelling, pain, numbness, bleeding, a blocked feeling in the sinus, short-lived dizziness
Less common, later	Infection, the graft becoming exposed or failing, not enough bone for implants
Rare but serious	Lasting numbness of the cheek or upper teeth, an opening between the sinus and mouth, long-term infection needing the graft removed

The leaflet gives figures for each. For example, a membrane tear was reported in about 19% of external procedures and 3.8% of internal ones. Rates vary between surgeons and cases, so ask your surgeon about their own.

When to get help

The Cambridge leaflet advises contacting the clinic if:

• swelling or pain gets worse after two days, or doesn't ease over time
• bleeding hasn't stopped by two days, or is bright red and continuous
• you think the graft has moved after sneezing or blowing your nose
• you have a fever or feel generally unwell

Abroad, call your clinic first. Save its number before surgery and ask whether it has an out-of-hours contact.

Flying after a sinus lift

Changes in air pressure during a flight can affect the sinuses, and in the British Dental Journal review a sinus lift or bone graft has the longest suggested wait of any procedure listed. That 2023 review suggests waiting at least two weeks after a sinus lift or bone graft, provided there's no pain, swelling or bleeding. The summary of the same review mentions six weeks after a sinus lift, so the safe interval for you is your surgeon's decision. Read flying after dental treatment for the full table of waiting times.

How a graft changes a trip to Vietnam

A graft can add a trip, or at least make the first trip longer:

• Graft with the implant. If the surgeon can place the implant during the sinus lift, you may still manage two trips. The first trip needs to be long enough to allow at least two weeks after surgery before you fly.
• Graft first, implant later. If the bone needs to heal before the implant goes in, plan for a graft trip, an implant trip months later, and a crown trip after that.

Put the surgery at the start of the trip so the last two weeks are free for healing. Ask the clinic to confirm, from your scan, whether you'll need a graft before you book flights. Planning your visits explains how to plan trip length, and the trip planner shows a sample implant schedule. A bone graft or sinus lift makes your trip longer than the sample.

Questions to ask the surgeon

• Do I need a sinus lift or bone graft, and what does the scan show?
• Which approach will you use, and can the implant go in at the same time?
• Which graft material do you use?
• How many trips should I plan for, and how long should each one be?
• When is it safe for me to fly?
• What happens if the graft doesn't take?

Dental implants covers the rest of the treatment, from the first scan to the final crown.