If you have a missing or damaged tooth near the back of your upper jaw, you may be a good candidate for tooth replacement with a dental implant. However, the position or size of your sinus cavities may create challenges for placing the implant. Sinus grafting is a procedure that addresses these challenges, and that helps to ensure the stability and durability of your new tooth.

Dr. Israel Puterman has years of experience conducting sinus grafting and other implant-related procedures for patients. He is one of a few doctors to have completed a three-year residency in Implant Dentistry in addition to being a specialist in Periodontics. This combined expertise allows him to place implants effectively while resolving a variety of sinus and bone-related concerns.

The Purpose of Sinus Grafting

Sinus cavities are natural features of the skull: empty spaces between the bones of your face around your nose and eyes. When you lose a tooth in the back of your mouth, bone in the area of the lost tooth may shrink as much as 30-50% within six months. This can cause the sinuses to enlarge. As a result, your jaw may not have a strong enough foundation to retain a dental implant. 

Patients who have this problem, may benefit from sinus grafting. The procedure adds bone to the lowest level of the sinus. This lifts the sinus to its original, higher position, and it creates a surface for placing the dental implant. The procedure provides very predictable outcomes, and Dr. Puterman will often perform bone grafting and place dental implants as part of the same surgery.

How Sinus Grafting Works

During your initial appointment with Dr. Puterman, he will evaluate whether you could benefit from a dental implant and determine the additional treatments you may need for a durable, attractive, and effective result. If he will be restoring a tooth in the back of your jaw, he will examine how much bone there is below the sinus. Patients who don’t have enough bone may be good candidates for sinus grafting.

Patients sometimes want to know whether the procedure can cause future problems with the sinuses. Fortunately, this is not the case, and grafting should not contribute to chronic sinus problems. In reality, a patient who has a typical dental implant procedure and a patient whose surgery includes sinus grafting are unlikely to notice a big difference in their experience. Sinus grafting does not cause any more discomfort than getting a dental implant alone; it is simply a way of altering sinuses that are too large or in a challenging location.

Dr. Puterman can use one of two methods to conduct the procedure:

Crestal approach. Some patients only require a small amount of bone to restore the sinus. Dr. Puterman will come in from the site where the dental implant will eventually go and fill the lower portion of the sinus with bone grafting material. Over time, this material will strengthen and become part of the jaw’s natural bone.

Lateral window. Patients who need a larger amount of bone restored may benefit from this approach. Dr. Puterman will make a small window along the jaw bone, raise the position of the sinus membrane, and fill the lower part of the cavity with grafting material.

In this x-ray, the arrows are pointing to the sinus graft that was placed around the implant.

And this is what the same implant looks like in the mouth. It’s the 2nd tooth from the back on the top jaw:


Before & After Gallery

What Patients Can Expect with Sinus Grafting

 Patients will receive gentle, professional, and efficient treatment in Dr. Puterman’s care. On the day of your procedure, Dr. Puterman will:

  • Employ sedation and anesthetic techniques to support your comfort.
  • Use a PiezoSurgery instrument to conduct the surgery. This technique will be very gentle on the bone as compared to a drill, and it will promote safety and accuracy during your procedure.
  • Provide you with L-PRF. This is an advanced treatment that encourages a faster recovery by using your body’s own natural ability to heal and is also used to speed healing in the fields of orthopedic surgery, plastic surgery, dermatology, neurology and diabetic wound healing.
  • Give you a specific anti-inflammatory regimen using both medication and natural homeopathic supplements clinically proven to reduce post-surgical swelling.

If you are receiving a dental implant at the same time as sinus grafting, Dr. Puterman will place the implant in a way that offers an attractive, lasting, and comfortable outcome. His goal is to create a result that looks so much like one of your original teeth that your dentist will have a difficult time spotting it in your mouth. His advanced training and years of practice contribute to this type of outcome. Along with sinus grafting, the techniques Dr. Puterman utilizes will restore your smile with a functional and natural-looking tooth.

If you have a missing or damaged tooth, visit Dr. Puterman to learn about dental implants and related treatments, such as sinus grafting. Patients can schedule an appointment online or by phone at (301) 652-0939.