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Sinus Lift Munich - Bone Augmentation Implantology | Dentist Christina Dickel

Q: Is a sinus lift painful?

No. The procedure is performed under local anesthesia — you will not feel any pain during the operation. After the procedure, mild to moderate discomfort may occur, which can be well controlled with pain medication (e.g., ibuprofen). Upon request, we additionally offer nitrous oxide, twilight sedation, or general anesthesia.

Q: How long does healing take after a sinus lift?

The healing time depends on the technique: For an internal sinus lift, we expect 4–6 months; for an external sinus lift, 6–9 months until the bone is sufficiently stable for implantation. Initial wound healing (swelling, suture removal) takes approximately 1–2 weeks.

Q: Can the implant be placed at the same time as the sinus lift?

With an internal sinus lift: Yes, the implant is usually placed in the same session since sufficient residual bone for primary stability is still present. With an external sinus lift: Only if at least 3–4 mm of residual bone is available. Otherwise, the implant is placed in a second procedure after 6–9 months of healing.

Q: How much does a sinus lift cost?

Costs vary depending on the technique (internal/external), materials, and scope. Since every case is individual, we prepare a detailed treatment and cost plan after the CBCT diagnostics. Installment payments are available. Private insurers frequently cover costs partially or fully.

Q: Does health insurance cover the sinus lift?

Statutory health insurance (GKV) does not cover the sinus lift, as it is an implantological service not included in the statutory benefit catalog. The GKV only pays a fixed subsidy for the dental prosthesis on the implant (60–75% of standard care depending on the bonus booklet). Private insurers frequently reimburse the sinus lift — depending on the plan.

Q: What is the difference between an internal and external sinus lift?

The internal sinus lift is performed through the implant bed (from below), is minimally invasive, and allows bone gain of 2–4 mm. It is suitable for a residual bone height of 5–8 mm. The external sinus lift uses a lateral bone window, is more extensive, but allows bone gain of up to 10+ mm and is used when residual bone height is under 5 mm.

Q: What are the risks of a sinus lift?

The sinus lift is a well-researched and safe procedure. The most common complication is perforation of the Schneiderian membrane (5–20% of cases), which can usually be repaired during the procedure. Swelling and bruising after the operation are normal. Rare complications include post-operative bleeding, infection, or sinusitis. We will inform you thoroughly during the preliminary consultation.

Q: Can I fly after a sinus lift?

No, you should not fly during the first 2 weeks after the sinus lift. Pressure changes in the aircraft cabin (during takeoff and landing) can negatively affect healing and stress the delicate Schneiderian membrane. Please plan air travel accordingly.

Q: What happens if the sinus membrane tears?

A perforation of the Schneiderian membrane occurs in 5–20% of cases and is the most common intraoperative complication. Small perforations can usually be repaired immediately with a resorbable collagen membrane. In the case of larger tears, the procedure is discontinued and repeated after complete healing (approximately 3–6 months).

Q: How long after a sinus lift should I avoid blowing my nose?

You should not blow your nose for at least 2–3 weeks. Blowing your nose creates overpressure in the maxillary sinus, which can displace the bone graft material or damage the healing membrane. Let your nose run or dab gently. When sneezing, open your mouth to release the pressure.

When insufficient bone height exists in the upper jaw molar area for implants, a sinus lift enables targeted bone augmentation. As an experienced implantologist in Munich, Dentist Christina Dickel performs both internal and external sinus lift procedures to create optimal conditions for long-term stable dental implants.

Inhaltsverzeichnis

What Is a Sinus Lift?

A sinus lift (also known as sinus floor elevation or sinus augmentation) is a surgical procedure for bone augmentation in the lateral upper jaw. The goal is to create sufficient bone volume so that dental implants can be securely and permanently anchored.

To understand why a sinus lift is necessary, it helps to look at the anatomy: The maxillary sinus (sinus maxillaris) is the largest of the paranasal sinuses and is located directly above the posterior tooth region of the upper jaw. It is lined with a thin mucous membrane called the Schneiderian membrane (membrana Schneideri). The jawbone between the oral cavity and the maxillary sinus is often naturally thin in this area — in some people, the bone height is only a few millimeters.

After the loss of posterior teeth in the upper jaw, a dual process begins: On one hand, the jawbone deteriorates because the chewing stimulus is absent (bone atrophy). On the other hand, the maxillary sinus naturally expands over the course of life (pneumatization). Both factors together mean that the remaining bone height is often insufficient for an implant — an implant typically requires at least 8-10 mm of stable bone.

During a sinus lift, the Schneiderian membrane is carefully detached from the sinus floor and repositioned upward (cranially). Bone graft material is then placed into the created space — either autogenous bone, bone substitute material, or a combination of both. Over the following months, this material is remodeled by the body into load-bearing, native bone. Only then — or with sufficient primary stability, simultaneously — can the implant be placed.

The sinus lift is one of the most thoroughly researched and successful procedures in dental implantology. With a success rate of over 95%, it is considered the gold standard for bone augmentation in the posterior upper jaw region.

Anatomie der Kieferhöhle: Knochenhöhe und Sinusboden für Sinuslift — Die Kieferhöhle (Sinus maxillaris) und der Kieferknochen: Warum die Knochenhöhe entscheidend für Implantate ist.

Internal vs. External Sinus Lift

There are two established techniques for the sinus lift, which differ in approach, bone gain, and invasiveness. Which method is suitable for you depends primarily on the existing residual bone height.

	Internal Sinus Lift	External Sinus Lift
Access	Through the implant bed (from below)	Lateral bone window (lateral)
Bone Gain	2–4 mm	Up to 10+ mm
Indication	Residual bone height 5–8 mm	Residual bone height < 5 mm
Simultaneous Implantation	Yes, usually	Often staged (after 6–9 months)
Procedure Duration	30–45 minutes	60–90 minutes
Healing Time	4–6 months	6–9 months
Invasiveness	Minimally invasive	More extensive

Interner vs. Externer Sinuslift: Zwei Techniken im Vergleich — Interner und externer Sinuslift: Zwei bewährte Techniken für den Knochenaufbau im Oberkiefer.

Internal Sinus Lift (Closed Technique)

With the internal sinus lift, access is made through the implant bed itself — no additional incision is needed. Using special instruments (osteotomes), the sinus floor is carefully elevated and the Schneiderian membrane is repositioned upward. Bone graft material is introduced through the same opening. Since sufficient residual bone is present (5–8 mm), the implant can be placed in the same session.

Advantages: minimally invasive, shorter procedure time, less swelling, faster healing, implantation possible in one session.

External Sinus Lift (Open Technique / Lateral Approach)

With severely reduced bone height (under 5 mm), the external sinus lift is the method of choice. A small bone window is prepared in the lateral wall of the maxillary sinus. Through this window, the Schneiderian membrane becomes visible and can be carefully elevated under direct vision. The resulting space is filled with bone graft material, the bone window is closed, and the mucosa is sutured.

The external sinus lift allows for significantly greater bone gain (up to 10 mm and more) and can be performed even with very low residual bone height. Typically, the implant is placed in a second procedure after a healing period of 6–9 months.

Both Techniques at Our Practice

At our practice, we routinely perform both sinus lift techniques. Which procedure is optimal for you is determined based on three-dimensional CBCT diagnostics, which allow millimeter-precise measurement of the existing bone height.

When Is a Sinus Lift Necessary?

Not every patient who needs an implant in the upper jaw requires a sinus lift. The decision depends on the individual bone situation, which we measure with millimeter precision using state-of-the-art 3D diagnostics (CBCT — Cone Beam Computed Tomography).

A sinus lift is generally indicated when:

The residual bone height in the posterior upper jaw is less than 8 mm — an implant requires at least 8–10 mm of stable bone for secure anchorage.
Teeth in the posterior upper jaw have been missing for an extended period — after tooth loss, the bone continuously deteriorates. The longer the gap exists, the more bone is lost.
The maxillary sinus is heavily pneumatized — in some people, the maxillary sinus naturally expands significantly and displaces the jawbone. This can occur even when teeth are still present.
Periodontitis has caused bone loss — chronic gum inflammation destroys the jawbone and may require augmentation even after successful treatment.

CBCT diagnostics as the basis for decision-making: At our practice, we have our own CBCT unit that creates three-dimensional X-ray images of the jaw. Unlike two-dimensional X-rays, CBCT allows us to measure the exact bone height, width, and density, as well as assess the course of nerve pathways and the extent of the maxillary sinus. This precise planning is the foundation for a safe and predictable sinus lift.

If sufficient bone is present (over 8–10 mm), the implant can be placed directly without a sinus lift — the procedure is only performed when it is truly necessary.

DVT 3D-Diagnostik für präzise Knochenaufbau-Planung — Digitale Volumentomographie (DVT): Millimetergenaue 3D-Planung für sicheren Knochenaufbau.

Treatment Procedure

A sinus lift is a plannable procedure that is performed on an outpatient basis at our practice. Here you can learn step by step how the treatment proceeds:

Einheilungszeit nach Knochenaufbau: Zeitlicher Ablauf bis zur Implantation — Von der OP bis zum Implantat: Die Einheilungsphase nach dem Knochenaufbau.

1. CBCT Scan and 3D Planning

The process begins with a three-dimensional CBCT scan of your upper jaw. Using the 3D data, we measure the exact residual bone height, assess the maxillary sinus, and plan the optimal implant position. Based on this, we determine whether an internal or external sinus lift is required.

2. Consultation and Informed Consent

In a detailed preliminary consultation, we explain the planned procedure, discuss alternatives, and answer all your questions. You will receive a detailed treatment plan and a cost estimate for your insurance.

3. The Procedure

The sinus lift is typically performed under local anesthesia. Upon request, we additionally offer nitrous oxide sedation, twilight sedation, or general anesthesia — ideal for anxious patients or for longer procedures.

Internal sinus lift: Access through the implant bed, elevation of the membrane with osteotomes, placement of bone graft material, simultaneous implantation. Duration: approximately 30–45 minutes.

External sinus lift: Preparation of a lateral bone window, detachment of the Schneiderian membrane under direct vision, filling with bone graft material, closure of the window, suturing. Duration: approximately 60–90 minutes.

4. Healing Phase

The placed bone graft material needs time to remodel into stable, native bone. The healing time is 4–6 months for an internal sinus lift and 6–9 months for an external sinus lift. During this phase, we conduct regular follow-up appointments.

5. Implantation (for Staged Approach)

After successful bone healing — documented by a follow-up CBCT scan — the implant is placed into the newly augmented bone. After an additional healing period of 3–6 months, the prosthetic restoration can proceed.

6. Prosthetic Restoration

Once the implant has firmly integrated, the final dental prosthesis is fabricated and placed — at our practice, thanks to CEREC technology, often in just one session. The result: a stable implant with a natural-looking crown.

Materials: Autogenous Bone and Bone Substitutes

Various bone graft materials are available for the sinus lift. The choice of material depends on the defect size, the individual bone situation, and personal preferences. We often use a combination of different materials to achieve optimal results.

Knochenaufbau-Materialien: Eigenknochen, Fremdknochen und synthetisches Material — Materialien für den Knochenaufbau: Eigenknochen, xenogenes und synthetisches Ersatzmaterial.

Autogenous Bone (Autologous Graft)

Autogenous bone is considered the gold standard in bone augmentation. It is harvested from the patient themselves — usually from the jaw angle, the chin, or for larger needs from the iliac crest. Autogenous bone has a decisive advantage: it contains living bone cells and growth factors and is therefore osteoinductive — it actively stimulates new bone formation.

Disadvantage: A second surgical site (donor site) is required, which makes the procedure somewhat more extensive and can lead to additional discomfort at the harvest site.

Xenograft Material (Biological Bone Substitute)

Xenograft bone substitute materials are derived from animal bone (usually bovine, i.e., cattle bone) and processed so that only the mineral bone structure remains. Well-known products like Bio-Oss have been clinically proven for decades and are excellently documented. They serve as an osteoconductive scaffold — the body's own bone grows into the structure and gradually replaces the material.

Advantage: No second surgical site, very well researched, slow resorption provides long-term volume stability.

Synthetic Bone Substitute (Alloplastic)

Synthetic materials such as tricalcium phosphate (TCP) or hydroxyapatite are manufactured in the laboratory and are completely biocompatible. They are fully resorbable — the body breaks them down over time and replaces them with native bone.

Advantage: No harvest site, no animal material, fully synthetic and resorbable.

Our Approach in Practice

At our practice, we use both autogenous bone and bone substitute materials — often in combination. Autogenous bone provides the biological growth factors, while bone substitute material serves as a stable scaffold and ensures long-term volume. Which materials are best suited for you will be discussed individually during the consultation. Learn more: Bone Augmentation for Implants.

Healing and Aftercare

Proper aftercare is crucial for the success of a sinus lift. The procedure involves the maxillary sinus — a cavity connected to the airways. Therefore, some special behavioral guidelines apply that differ from other dental surgical procedures.

Healing Process

First 1–2 weeks: Initial wound healing includes reduction of swelling, suture removal (after approximately 10 days), and subsiding of any discomfort. Mild swelling and bruising (hematomas) are normal and no cause for concern.

4–9 months: During this phase, the body remodels the placed bone graft material into native, load-bearing bone. The duration depends on the technique used: 4–6 months for internal sinus lift, 6–9 months for external sinus lift. During this time, you can go about your daily life normally.

Follow-up CBCT scan: Before implantation, we verify with a CBCT scan whether sufficient new bone has formed and the implant can be safely placed.

Important Behavioral Guidelines After the Sinus Lift

The Schneiderian membrane must heal undisturbed. Pressure changes in the maxillary sinus can disrupt healing. Please observe the following:

Do not blow your nose (2–3 weeks): This is the most important rule. Blowing your nose creates overpressure in the maxillary sinus, which can displace the placed material or damage the healing membrane. Simply let your nose run or dab gently.
Sneeze with your mouth open: If you need to sneeze, do so with your mouth open to avoid pressure buildup in the maxillary sinus.
Do not fly (2 weeks): Pressure changes during air travel (takeoff and landing) can negatively affect healing.
No straws, no breathing through a snorkel: Sucking creates negative pressure that can disrupt healing.
Soft diet (1–2 weeks): Avoid hard chewing on the operated side.
Elevate your head while sleeping: An extra pillow reduces swelling.
Do not smoke: Smoking significantly impairs wound healing and markedly increases the risk of complications.
No exercise for 1 week: Physical exertion can promote post-operative bleeding.

Follow-Up Appointments

After the sinus lift, we will see you for regular follow-up appointments: in the first week for wound monitoring, after 10 days for suture removal, and in the following months to monitor bone healing. A final CBCT check is performed before implantation.

Costs and Insurance Coverage

The costs for a sinus lift depend on the technique used, the complexity, and the bone graft material. Here is an overview of the reimbursement situation:

Statutory Health Insurance (GKV)

The sinus lift is not covered by statutory health insurance. Since implants are not included in the statutory health insurance benefit catalog, preparatory procedures such as bone augmentation are also not covered by the GKV.

However, the GKV contributes to the final dental prosthesis (crown on the implant) with a fixed subsidy. This fixed subsidy covers 60% of the standard care costs. With a consistently maintained bonus booklet, the subsidy increases to up to 75% (5 years: 70%, 10 years: 75%).

Private Health Insurance (PKV)

Private health insurers frequently cover the sinus lift partially or fully — depending on your individual plan. We are happy to prepare a detailed treatment and cost plan that you can submit to your private insurer before treatment.

Installment Payments

For out-of-pocket costs, we offer the option of installment payments to spread the costs over several months. Financial circumstances should not be an obstacle to optimal dental care. Please do not hesitate to contact us — we will find a solution.

Why Dr. Dickel for Your Sinus Lift?

A sinus lift requires surgical experience, precise planning, and state-of-the-art technology. At our practice, we combine all of these:

In-house CBCT 3D diagnostics: Millimeter-precise three-dimensional planning with our own CBCT unit — no referrals needed for imaging.
DGI member: As a member of the German Society of Implantology, we bring solid expertise in implantological surgery.
Additional professional societies: Member of DGZMK (Dental, Oral and Maxillofacial Medicine) and DGAZ (Aesthetic Dentistry).
Both sinus lift techniques: We master both the internal and external sinus lift and select the optimal method for you.
Experience with all materials: Autogenous bone, xenograft, and synthetic bone substitutes — we use the material best suited to your case.
CEREC technology: After successful implantation, we fabricate your dental prosthesis digitally and often in a single session.
All sedation options: Whether nitrous oxide, twilight sedation, or general anesthesia — we offer the right solution for every patient and every anxiety level. Ideal for anxious patients.

Schedule a consultation — we will assess your bone situation with a CBCT scan and advise you individually on the available options.

OP-Bereich der Zahnarztpraxis Dr. Dickel für chirurgische Eingriffe — Unser chirurgischer Behandlungsraum: Modernste Ausstattung für sichere Knochenaufbau-Eingriffe.

Kosten im Überblick

Leistung	Preisrahmen	Hinweis
Internal Sinus Lift	Individual based on complexity	Minimally invasive procedure through the implant bed. Costs depend on the bone graft material used.
External Sinus Lift	Individual based on complexity	More extensive procedure with a lateral bone window. Higher costs due to longer procedure duration and greater material quantities.
Sinus Lift + Simultaneous Implantation	Individual based on complexity	Combination of sinus lift and simultaneous implant placement in one session. Total costs may be lower than two separate procedures.

Internal Sinus Lift

Individual based on complexity

Minimally invasive procedure through the implant bed. Costs depend on the bone graft material used.

External Sinus Lift

Individual based on complexity

More extensive procedure with a lateral bone window. Higher costs due to longer procedure duration and greater material quantities.

Sinus Lift + Simultaneous Implantation

Individual based on complexity

Combination of sinus lift and simultaneous implant placement in one session. Total costs may be lower than two separate procedures.

The sinus lift itself is not covered by statutory health insurance (GKV). The statutory insurer only contributes a fixed subsidy toward the final dental prosthesis on the implant (60–75% of standard care, depending on the bonus booklet).

Private health insurers frequently cover the sinus lift partially or fully — depending on the plan. We are happy to prepare a detailed treatment and cost plan for submission to your private insurer.

For out-of-pocket costs, we offer installment payments to spread the costs over several months. Financial circumstances should not be an obstacle to your optimal care.

Risiken und Sicherheit

The sinus lift is one of the most thoroughly researched and safest procedures in dental surgery. The success rate is over 95%. As with any surgical procedure, complications can occur, but they are generally manageable.

Perforation of the Schneiderian membrane

Most common complication (5–20%)

Small perforations are repaired intraoperatively with collagen membranes. In the case of larger tears, the procedure is discontinued and repeated after 3–6 months. Ultrasonic instruments (piezosurgery) reduce the risk.

Swelling and bruising

Common (normal healing response)

Cooling during the first 48 hours, head elevation, anti-swelling medication. Usually subsides within 5–7 days.

Post-operative bleeding

Occasional

Slight post-operative bleeding on the day of surgery is normal. Bite on a gauze pad, rest physically, no exercise. Contact the practice if bleeding persists.

Infection / graft loss

Rare (< 2%)

Prophylactic antibiotic administration, sterile surgical conditions, smoking cessation. In case of signs of infection (fever, severe pain, purulent discharge), immediate treatment.

Sinusitis (maxillary sinus infection)

Rare

Decongestant nasal drops, antibiotics if necessary. Good aftercare and adherence to behavioral guidelines (no nose blowing) significantly minimize the risk.

Numbness

Very rare, temporary

May occur due to swelling in the surgical area and usually resolves completely within a few weeks. Permanent nerve damage is extremely rare.

At our practice, we minimize risks through precise CBCT-guided 3D planning, the use of modern instruments, sterile surgical conditions, and close aftercare with regular follow-up appointments.

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