Question Sinus Lift for Dental Implants - Any potential issues?

[Pearlman]

Hello,
I am scheduled for a dental appointment for inserting two implants in the upper jaw (pre-molar and molar) and the Dentist mentioned that the procedure would also involve a sinus lift by 4mm. Will it result in any kind of chronic condition afterwards with regards to equalisation using valsalva technique when diving? I am worried about it affecting my diving hobby so would like to hear from a medical expert.

Thank You in Advance!

 

[Duke Dive Medicine]

Hello,
I am scheduled for a dental appointment for inserting two implants in the upper jaw (pre-molar and molar) and the Dentist mentioned that the procedure would also involve a sinus lift by 4mm. Will it result in any kind of chronic condition afterwards with regards to equalisation using valsalva technique when diving? I am worried about it affecting my diving hobby so would like to hear from a medical expert.

Thank You in Advance!

It's unlikely to affect your ear equalization but it could affect your sinus equalization depending on which approach is used, especially in the short term. You'll be out of diving for a few weeks. More specific questions are best answered by the surgeon who is performing the procedure. I would recommend asking him/her how it will affect the draining / pressure equalization of the sinuses.

Best regards,
DDM

 

[jmark18]

As mentioned there are 2 approaches to do this. If it is just from the empty ridge then there should be an easy short recovery and you could get back to diving in a few weeks. If it is from the side you should wait at least 4-6 months to ensure the bony opening has healed completely.

 

[O-ring]

Not a medical expert - just a dude with a sinus lift and an implant. As with all things medical/dental each case is unique but I had an extraction, sinus lift and implant of #3 molar about 6 years ago or so and have done a bunch of diving since then with no problems. Like you, I was worried about it too and that first dive I just took it real slowly and paid careful attention to my sinuses, teeth, etc. No problems at all and I have done a bunch of diving since then. Mine was from the side and (mostly due to other circumstances) I was out of the water for quite a while before that first dive post-procedure.

 

[Pearlman]

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B

It's unlikely to affect your ear equalization but it could affect your sinus equalization depending on which approach is used, especially in the short term. You'll be out of diving for a few weeks. More specific questions are best answered by the surgeon who is performing the procedure. I would recommend asking him/her how it will affect the draining / pressure equalization of the sinuses.

Best regards,
DDM

It may be just my bias but I believe local medical graduates are unfamiliar with or not sufficiently equipped with knowledge of diving related medical issues to make that judgement. More likely that it was one of the 1000s of fleeting topics they had to cram for their exams and therefore without adequate focus and subsequent recall for the average dentist here.

That aside - what do I have to do differently apart from the valsalva technique to achieve sinus equalisation?

As mentioned there are 2 approaches to do this. If it is just from the empty ridge then there should be an easy short recovery and you could get back to diving in a few weeks. If it is from the side you should wait at least 4-6 months to ensure the bony opening has healed completely.

Could you please elaborate on what is the “empty ridge” vs the sides? The dental X-ray showed two large hollows of my sinus on either side of my nose and the one side above the bone where the premolar implant will sit needs to be lifted.

I found this article after I posted this question and shared it with my dentist yesterday : Sinus Membrane Lift DAN SA

Leaving aside equalisation problems and considering the huge cost (of dental implants) and potentially other issues with the yet to fuse bone graft and possible displacement of newly inserted implants, I am more inclined now to follow that article to the T. Which means I will not make that diving vacation in May this year and postpone it by 6mo to Sept. I have a few test dives coming up in March after my regulator servicing workshop so I even postponed the implant surgery to the week after that instead of doing it this week.

 

[O-ring]

Not sure if you have discussed this with your oral surgeon yet, but there is quite a bit of spacing needed between those appointments/procedures (or at least there was in my case). I had the extraction and then I think it was a couple of months or so before I had the sinus lift. Once the sinus lift was done it was another few months of healing before I had the actual implant installed. You might be able to work your trip in depending on the timeline of those appointments.

 

[Pearlman]

Not sure if you have discussed this with your oral surgeon yet, but there is quite a bit of spacing needed between those appointments/procedures (or at least there was in my case).

That’s right. Extraction was done a year back. And the plan is to insert the implant screws with bone graft and abutment in March and give it 6mo to heal before attaching the crown.

The DAN article seems to suggest that even pressure on the outer skin of the face (and mouthpiece clamping for a hour) could displace the implant if the bone graft is not properly fused? I am not taking chances, and besides that my usual dive vacations are normally spaced 5mo apart in any case. It’s just a matter of postponing one trip and stretching the vacation interval this year to 11mo … I am doing a days diving with my newly serviced 2nd stage in March in any case so I’ll remain content with that.

 

[Duke Dive Medicine]

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B

It may be just my bias but I believe local medical graduates are unfamiliar with or not sufficiently equipped with knowledge of diving related medical issues to make that judgement. More likely that it was one of the 1000s of fleeting topics they had to cram for their exams and therefore without adequate focus and subsequent recall for the average dentist here.

That aside - what do I have to do differently apart from the valsalva technique to achieve sinus equalisation?

An oral surgeon should still understand how sinuses drain and how the procedure that he or she is performing could affect that drainage. Re equalization, under normal conditions, the sinuses equalize themselves. A Valsalva maneuver shouldn't be necessary. If the mucous membrane in the sinus is inflamed, this equalization doesn't happen automatically, and the sinuses are not nearly as sensitive to pressure differentials on descent so you likely wouldn't feel anything if you were experiencing sinus barotrauma of descent.

Best regards,
DDM