Sinus lift: an established step in dental implant treatment
A sinus lift is one of the most established surgical procedures in implant dentistry, performed routinely for more than 30 years with predictable, reliable results (Moreno Vazquez et al., Journal of Oral and Maxillofacial Surgery, 2014).
Many patients who come to Dr Haim Aseriel's clinic in Jerusalem after losing upper back teeth discover that the remaining bone is not enough for a direct implant. A dental sinus lift is a proven answer to this problem, including in complex situations. The surgery is performed at the clinic together with Dr Yves Weinberg, head of the Department of Oral and Maxillofacial Surgery at Barzilai Medical Center, and everything can be explained to you in English.
What is a sinus lift, and when is it needed?
A patient who lost upper molars years ago asks why an implant cannot simply be placed. The panoramic X-ray shows that the maxillary sinus has expanded downward and taken up the bone volume needed, a process called pneumatization.
A sinus lift is needed when the bone height beneath the floor of the maxillary sinus is not enough to hold a stable implant.
The maxillary sinus is an air space directly above the roots of the upper back teeth. After an extraction, the bone resorbs and the sinus expands, reducing the bone available. The lower jaw has no comparable limit; the back of the upper jaw is limited precisely by this structure. That is why sinus lift surgery is done only in the upper jaw.
In some cases, zygomatic implants can also be considered as an alternative for patients with extreme bone loss.
Sinus lift procedure: open vs closed technique
There are two main ways to perform a sinus lift, and the choice depends mainly on the remaining bone height, as measured on 3D imaging.
A closed sinus lift (crestal or osteotome approach) usually suits cases with a moderate remaining bone height, enough to hold the implant at the time of surgery. The surgeon reaches the sinus floor through the same opening where the implant is placed and gently lifts the membrane upward, with a smaller incision. An open sinus lift (lateral window approach) is for low bone height: a window is opened directly in the side wall of the sinus, giving full access and room for more graft material. A sinus lift can be combined with a dental bone graft when wider bone reconstruction is needed.
| Criterion | Closed sinus lift | Open sinus lift |
|---|---|---|
| Approach | Crestal / osteotome approach | Lateral window approach |
| Remaining bone height | Moderate | Low |
| How it is done | Through the same opening where the implant is placed | A window is opened directly in the side wall of the sinus |
| Duration | Usually under an hour | Usually about an hour to an hour and a half |
How to prepare for sinus lift surgery
Before a sinus lift, the surgeon will perform or request:
- Cone beam CT (CBCT): precise measurement of the height and width of the existing bone, taken at the clinic on a Planmeca ProMax 3D.
- Sinus health check: making sure there is no active inflammation or blockage.
- Blood tests: assessment of general health and blood sugar.
- Smoking: stopping before surgery and during healing is recommended, as the surgeon instructs.
- Blood thinners: do not stop or change them on your own; any change is made only with the prescribing doctor.
How long does sinus lift surgery take? The day of surgery
An open sinus lift usually takes about an hour to an hour and a half, and a closed sinus lift is shorter, usually under an hour.
The surgery is done at the clinic under local anesthesia, sometimes combined with light oral sedation on prescription. If sedation is given, follow the instructions you receive beforehand.
60–90 min
typical length of an open sinus lift
After a sinus lift, come with an adult who can drive you home. A cold compress on the cheek, 10 to 20 minutes at a time, helps limit swelling in the first 24 hours.
An oral and maxillofacial surgeon follows the patient through every stage, from the first examination to implant placement.
Sinus lift recovery: what to expect
Why does recovery feel different from one patient to another? The technique, the amount of graft placed and pain management afterwards all directly affect healing.
Initial recovery after a sinus lift usually takes one to two weeks, and most patients return to their routine within a week.
1. The first days
In the first days after surgery, local swelling, moderate discomfort and sometimes mild bruising are normal reactions.
2. Pressure in the sinus
Avoid anything that creates pressure in the sinus, such as blowing your nose forcefully, blowing hard or swimming, following the surgeon's instructions.
3. Follow-up CT
When the implants were not placed during the sinus lift, the new bone is given a few months to mature; the waiting time depends on the graft type and the initial bone height. A CT then confirms that the bone height is sufficient, and only then are the dental implants placed, followed by a dental crown.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
Which materials are used in a sinus lift?
In a systematic review of 868 implants in 397 sinuses, implant survival was 99.6% when a graft material was used and 96% when the sinus was lifted without graft material, with 48 to 60 months of follow-up (Silva et al., International Journal of Oral and Maxillofacial Surgery, 2016).
The authors concluded that a sinus lift, with or without graft material, is a safe procedure with predictable results; a Cochrane review also found no evidence that one technique is better than another for implant survival (Esposito et al., Cochrane, 2014).
Graft materials
The graft material is chosen for each case: the patient's own bone, human donor bone, processed bovine bone (such as Bio-Oss) or a synthetic material.
PRF
PRF (platelet-rich fibrin) is a concentrate prepared from the patient's own blood. According to a meta-analysis of controlled trials, adding platelet concentrates such as PRF to the graft slightly increased the proportion of new bone, but had no effect on implant stability or bone height (Xie et al., Clinical Oral Investigations, 2025). PRF is prepared at the clinic, in its own centrifuge, and its use is considered case by case, at the surgeon's discretion.
99.6%
- implant survival with graft material
96%
- without graft material
Patients considering full mouth dental implants may also need a sinus lift in the back of the upper jaw.
Sinus lift side effects and complications
Perforation of the sinus membrane is the most common complication during surgery, occurring in 7% to 35% of cases depending on the surgeon's experience and the anatomy (Bathla & Fry, Journal of the Indian Society of Periodontology, 2018).
Possible complications after a sinus lift are mostly temporary and treatable.
Common, expected side effects include swelling, moderate pain and short-lived sinusitis. Membrane perforation can usually be repaired during the surgery. Infections after surgery are less common and are treated as the doctor decides, sometimes with prescription antibiotics. In a retrospective study of 472 sinus lifts, 1.7% of grafts failed (Jamcoski et al., BioMed Research International, 2023). According to a Cochrane review, sites that had a sinus lift had more complications than sites where short implants were placed without one (Esposito et al., Cochrane, 2014).
Sinus lift cost: what affects the price?
The cost of sinus lift surgery depends on the technique, the type of graft material, the number of areas treated and whether an implant is placed at the same time.
There is no flat price: after the examination and a cone beam CT, you receive a detailed written quote, and itemized receipts you can submit to your insurer (reimbursement depends on your policy). See also dental implant cost.
Can implants be placed without a sinus lift?
Yes, in some cases implants can be placed without a sinus lift, provided the remaining bone height is enough for a short implant or the implant position avoids the sinus.
- Short implants (5 to 8.5 mm) have been studied as an alternative to a sinus lift when the remaining bone height is 4 to 9 mm (Esposito et al., Cochrane, 2014).
- Angled implants (All-on-4 / All-on-6) may bypass the sinus completely.
- According to a systematic review, over the first five years results with short implants and with a sinus lift plus standard implants are similar; beyond 5 years a non-significant trend favored standard implants (Grunau & Terheyden, International Journal of Oral and Maxillofacial Surgery, 2023).
The decision is made after a precise anatomical assessment. In the retrospective study mentioned above, the implant success rate was 97.4% when the initial bone height was at least 4 mm (Jamcoski et al., BioMed Research International, 2023).
Sinus lift in Jerusalem: consultation at Dr Haim Aseriel's clinic
Sinus lift surgery is planned carefully on the basis of 3D imaging, never rushed. The clinic's dentists, together with an oral and maxillofacial surgeon and full mouth rehabilitation planning, follow each patient from the first examination to the final implant stage. Dr Haim Aseriel (DDS, NYU College of Dentistry) sees patients at 12 HaTnufa Street in Talpiot, south Jerusalem, open Sun 8:00–19:00 · Mon 9:00–19:00 · Tue–Wed 9:00–21:00 · Thu 8:30–21:00 · Fri 8:00–14:00, with no obligation after the consultation. You can also read patient reviews.
Sinus lift: frequently asked questions
A sinus lift is done at the clinic under local anesthesia, sometimes combined with light oral sedation by prescription, so the surgery itself should not hurt. In the first days afterwards, local swelling and moderate discomfort are expected; a cold compress on the cheek helps limit the swelling. Ask your dentist or pharmacist about pain relief.
Sometimes. In a closed sinus lift, when a moderate bone height remains, the implant is placed through the same opening during the same surgery. When the bone height is low and an open sinus lift is needed, the new bone is usually given several months to mature, a CT confirms that the bone height is sufficient, and only then are the implants placed.
Initial recovery after a sinus lift usually takes one to two weeks, and most patients return to their routine within a week. During this time, avoid anything that creates pressure in the sinus, such as blowing your nose forcefully, blowing hard or swimming. The new bone matures over several months.
Smoking does not necessarily rule out a sinus lift, but stopping before the surgery and during healing is recommended, as the doctor instructs. Mention smoking at the preliminary examination, together with medical conditions and medications, so the surgeon can assess the risk and plan the treatment.
Yes, in some cases implants can be placed without a sinus lift: when the bone height is enough for a short implant, or when the implant is angled to bypass the sinus. According to a Cochrane review, with 4 to 9 mm of remaining bone height no difference in failure was shown between short implants and a sinus lift, but sinus lifts had more complications.
Sources
- Jamcoski VH et al., BioMed Research International, 2023 – Link to study
- Silva LD et al., International Journal of Oral and Maxillofacial Surgery, 2016 – Link to study
- Esposito M et al., Cochrane Database of Systematic Reviews, 2014 – Link to study
- Grunau O & Terheyden H, International Journal of Oral and Maxillofacial Surgery, 2023 – Link to study
- Xie S et al., Clinical Oral Investigations, 2025 – Link to study
- Bathla & Fry, Journal of the Indian Society of Periodontology, 2018 – Link to study
- Moreno Vazquez JC et al., Journal of Oral and Maxillofacial Surgery, 2014 – Link to study
