Sinus Lift Surgery: Techniques, Instruments, and Kits in Modern Implantology

Introduction

Dental implants in the posterior maxilla often face a common challenge — insufficient bone height beneath the maxillary sinus. This limitation usually results from sinus pneumatization and bone resorption following tooth loss.

To overcome this issue and provide adequate bone volume for implant placement, clinicians perform a sinus lift, also known as sinus augmentation.
This article reviews the main sinus lift techniques, the essential surgical instruments, and advanced sinus lift kits that help clinicians perform the procedure safely, efficiently, and predictably.

1-What Is a Sinus Lift?

A sinus lift is a regenerative surgical procedure aimed at increasing bone height in the posterior maxilla by lifting the Schneiderian membrane (sinus membrane) and placing bone graft material underneath it.

The goal is to create a stable and well-integrated foundation for implant placement — either simultaneously with the lift or after a healing period.

2-Indications for Sinus Lift Surgery

• Insufficient residual bone height (<6–8 mm) in the posterior maxilla.
• Pneumatized maxillary sinus following tooth extraction.
• Bone resorption after long-term edentulism.
• Preparation for implant placement in the molar and premolar region.

3-Sinus Lift Techniques

a-Lateral Window Technique

The lateral window (direct) approach is the traditional method used when available bone height is less than 4–5 mm.
Procedure Steps:

1. A lateral window is created in the lateral wall of the maxillary sinus.
2. The Schneiderian membrane is carefully elevated.
3. Bone graft material (autograft, xenograft, or alloplast) is inserted beneath the membrane.
4. The site is covered with a membrane and sutured.

Advantages:

• Suitable for large augmentations.
• Direct visualization of the membrane.
  Disadvantages:
• More invasive; longer healing period.

b-Crestal (Internal) Approach

The crestal approach, or osteotome sinus lift, is less invasive and used when bone height is at least 6–8 mm.
Procedure Steps:

1. The osteotomy is prepared through the alveolar crest.
2. The sinus floor is gently fractured using osteotomes or hydraulic pressure.
3. Bone graft material is inserted to lift the sinus membrane.

Advantages:

• Minimally invasive.
• Can be performed simultaneously with implant placement.
  Disadvantages:
• Limited lift height.
• Higher risk of membrane perforation if not performed carefully.

4-Instruments and Tools for Sinus Lift Surgery

A-Basic Surgical Instruments

• Scalpel and surgical blades – for flap design and incision.
• Periosteal elevators – to reflect the mucoperiosteal flap.
• Bone scraper or rongeur – for bone harvesting or shaping.
• Suction and irrigation systems – to maintain a clean field and visibility.
• Curettes – to carefully elevate the Schneiderian membrane.
• Membrane holders and sinus elevators – for controlled membrane detachment.

B-Specialized Sinus Lift Instruments and Kits

1. Sinus Lift Burs and Drills

• Diamond-coated burs and dome-shaped drills are used to open the lateral wall without tearing the membrane.
• Stoppers are often included for depth control.
• Some kits include irrigation systems to reduce friction and prevent overheating.

Popular Systems:

• Hiossen CAS Kit
• Neobiotech SCA Kit
• Osstem Sinus Kit (CAS / ESSET)

2. Osteotomes

• Used mainly for the crestal approach.
• Designed to fracture the sinus floor and elevate the membrane mechanically.
• Often used in sequence, from smaller to larger diameters.

Advantages:

• Simple, low-cost tools.
• Excellent tactile feedback.

Optional Add-ons:

• Mallet for controlled tapping.
• Stopper system to prevent over-penetration.

3. Hydraulic or Pneumatic Sinus Elevation Systems

• Use fluid or air pressure to gently lift the sinus membrane.
• Minimize risk of perforation compared to osteotomes.

Examples:

• Hydro Lift System
• iRaise Sinus Lift System

Advantages:

• Uniform elevation.
• Enhanced safety and comfort for the patient.

4. Piezoelectric Surgery Units

• Piezoelectric instruments use ultrasonic microvibrations to cut bone while preserving soft tissues.
• Ideal for lateral window procedures with high precision and minimal risk of membrane damage.

Benefits:

• Micrometric cutting.
• Reduced trauma and faster healing.
• Clear visualization with less bleeding.

Popular Models:

• Mectron Piezosurgery®
• Satelec Piezotome®

5. Sinus Membrane Elevators

• Curved, thin-tipped instruments specifically designed to separate and elevate the Schneiderian membrane without perforation.
• Often available in multiple shapes to adapt to different sinus wall anatomies.

6. Bone Grafting and Membrane Application Tools

• Bone graft carriers – to deliver particulate graft material into the sinus cavity.
• Compactors and condensers – to gently compact grafts.
• Scissors and tweezers – for trimming and placing collagen membranes.

5-Bone Graft and Membrane Selection

Common grafting materials for sinus lift include:

• Xenografts (bovine-derived bone, e.g., Bio-Oss®)
• Allografts (DFDBA, FDBA)
• Alloplasts (synthetic HA/β-TCP)
• Autografts (from the mandibular ramus or chin)

Barrier membranes — such as collagen membranes or PTFE membranes — are used to cover the lateral window and protect the graft during healing.

6-Postoperative Care and Healing

• Antibiotics and anti-inflammatory medication are prescribed.
• Sinus precautions: Patients should avoid nose blowing, sneezing with closed mouth, or flying for at least 10–14 days.
• Healing typically takes 4–9 months, depending on graft material and bone quality.

Implant placement may be performed simultaneously (if sufficient primary stability exists) or after full healing.

7-Modern Innovations

Recent advancements in sinus lift surgery include:

• 3D digital planning and guided sinus surgery.
• Minimally invasive crestal systems with hydraulic lift.
• Piezo-assisted lateral approaches with enhanced precision.
• PRF (Platelet-Rich Fibrin) integration to accelerate healing.

These innovations enhance safety, reduce surgical time, and improve clinical outcomes.

Conclusion

Sinus lift surgery is a cornerstone procedure in implant dentistry, enabling successful implant placement in the atrophic posterior maxilla.
Using the right technique, instruments, and specialized kits ensures safety, precision, and predictable bone regeneration.

At West Dent, we offer a comprehensive range of sinus lift kits, surgical instruments, grafting materials, and membranes from trusted global brands — helping clinicians achieve outstanding results with confidence.

Contact us today to learn more about our advanced sinus lift solutions and implant surgery systems.