Treatment consultation
What to check when considering sinus floor elevation
Information to discuss when considering sinus floor elevation, including remaining bone height, approach, timing, and alternatives.
This general information is intended to help you prepare for a dental consultation. Decisions about your treatment require a clinical examination and appropriate tests.
During a consultation about implants in the upper back teeth, you may be told that there is not enough bone and a sinus lift is needed. Above these teeth is an air-filled space called the maxillary sinus. If the bone between its floor and the gums is thin, there may be insufficient space to place an implant.
Remaining bone height and CT assessment
Whether a sinus lift is needed, and which approach is suitable, depends on examination findings, including the height of the remaining bone.
Knowing the remaining bone height in millimeters can help you understand which approaches are being considered.
Whether CT imaging is needed may depend on the treatment site and purpose. When needed, it provides a three-dimensional assessment of the remaining bone and surrounding structures. Width is difficult to assess from a panoramic image alone.
Questions to ask during a consultation
"How much bone height remains, and which approach does that suggest?"
Two approaches
There are two main approaches.
- Crestal approach — the sinus floor is lifted through the opening prepared for the implant. This involves a smaller area
- Lateral window approach — a window is made through the side near the gum to lift the sinus floor. This involves a larger area
A crestal approach may be considered when some bone height remains, while a lateral window approach may be considered when the remaining height is insufficient.
Some studies comparing the two approaches reported differences in operating time and pain scores, but no statistically significant differences in bone gain, success rates, or complications.[1] Study populations and individual outcomes may differ, and the approach chosen depends on individual circumstances.
Alternatives that may be considered
Even when remaining bone is limited, there may be more than one applicable approach.
An analysis pooling 8 randomized controlled trials reported no statistically significant difference in failure rates between short implants (8 mm or less) and standard implants placed with sinus floor elevation (risk ratio 1.05, 95% confidence interval 0.68–1.75).[2] The analysis reported less marginal bone loss with short implants. Study findings do not determine an individual's outcome.
Short implants may therefore be one option to consider when bone is limited, depending on individual circumstances.
Questions to ask during a consultation
"Are there alternatives to a sinus lift in my case? If not, why not?"
Treatment duration and timing
Bone needs time to heal after grafting. Implant placement timing varies with the approach and individual circumstances, and several visits may be needed.
You can ask about the overall schedule and when follow-up visits are needed.
Known complications and what to check beforehand
Injury to the sinus membrane can occur. Treatment may proceed after the injury is managed, or the plan may need to be revised depending on its extent.
Before treatment, tell the clinician about any history of sinusitis or nasal surgery and whether you smoke, so these factors can be considered in the plan.
You can ask about possible complications and how they would be managed during the consultation.
Summary
| Confirmed | What to check |
|---|---|
| Remaining height | The measured height of the remaining bone |
| Approach | The proposed approach and the conditions for its use |
| Alternatives | Alternatives that may be considered, such as short implants |
| Duration | The overall treatment schedule and follow-up timing |
| Complications | Complications such as membrane injury and how they are managed |
References
[1] The Clinical Effectiveness Comparison Between Modified Crestal Approach and Lateral Window Sinus Floor Elevation. J Oral Rehabil. 2026;53(5):1027-1035. (Prospective study. Operating time and pain differed, but no statistically significant differences were found in bone gain, success rates, or complications. The follow-up period and sample size were limited.)
[2] Short implants (≤8 mm) versus standard implants with sinus floor elevation in the atrophic posterior maxilla: a systematic review and meta-analysis of randomized controlled trials. J Stomatol Oral Maxillofac Surg. 2026;127(5):102913. (Pooled analysis of 8 randomized controlled trials. The absence of a statistically significant difference in failure rates does not mean the two approaches are equivalent; the confidence interval is wide.)
This article provides general information about conditions and treatments. The figures cited are values reported in the referenced studies. Study populations and individual outcomes may differ, and these figures do not guarantee treatment results. The treatment needed and its timing may vary with the remaining bone, sinus condition, general health, and previous treatment. A specific diagnosis and treatment plan are determined through an in-person examination and tests by a clinician.