Do I Need a Sinus Lift or Zygomatic Implant?

Introduction

Worried your sinus issues might cause a concern? This article explains what the maxillary sinus is, why it matters for upper full-arch dental implants, and how we plan safely around it. You’ll learn when a sinus lift, short/tilted implants, or zygomatic implants are recommended, what each involves, and the key benefits and risks—so you can review your 3D scan with confidence and choose the least-invasive path to stable, long-lasting teeth.

What is the maxillary sinus?

You have a sinus on each side of your upper jaw, like small air “balloons” behind your cheeks. The roots of upper molars and premolars sit close to the sinus floor, so after tooth loss the sinus can “drop” a bit and the jawbone can shrink—reducing bone height for implants. A 3D CBCT scan helps us see this anatomy clearly and plan safely. Professional radiology guidance recommends cross-sectional imaging (typically CBCT) for implant site assessment, used judiciously to keep radiation as low as reasonably achievable.

When do patients need a sinus-related solution?

You may need a sinus-focused plan if you’re missing most upper back teeth, have worn dentures for years, or were told you “don’t have enough bone.” In these cases, standard-length implants may risk the sinus or lack stability, so we either add bone (sinus lift) or work around the sinus with alternative implant strategies. Evidence shows that several approaches—sinus lifts, short/tilted implants, or zygomatic implants—can all work well when matched to the patient’s anatomy and health.

Signs you might hear at a consult

• "There isn’t enough bone height under the sinus."
• “We can avoid grafting with short or tilted implants.”
• “With severe bone loss, zygomatic implants may be the safest path.”

Your Options (How we plan around the sinus)

• Sinus lift (sinus augmentation)

  A sinus lift gently raises the sinus membrane and places bone graft material to create more height for implants. It can be done through a small window on the side (lateral) or from the crest (internal/osteotome). Patient resources from oral-surgery societies outline how this works and why it’s used.

  What the research says: Systematic reviews report high implant survival after sinus lifts. Complications can include small membrane tears and, less commonly, temporary sinus symptoms; careful technique and case selection lower these risks

• Short/tilted implants to avoid the sinus

  When there’s moderate bone, we can often avoid a sinus lift by using short implants or by tilting posterior implants as part of an All-on-X plan. Recent meta-analyses and trials show comparable outcomes between short implants and longer implants with sinus elevation in many posterior-maxilla cases, though patient selection matters.

• Zygomatic implants (cheekbone implants)

  If bone is extremely thin or grafting has failed, zygomatic implants anchor in the cheekbone, bypassing the sinus. International consensus reports and systematic reviews show long-term ~96% survival and note that immediate loading (same-day fixed teeth) can perform as well as or better than delayed loading in properly selected patients. These are advanced procedures performed by experienced teams.

Pros and Cons