A sinus lift is the cosmetic procedure, adding bone to your upper jaw, within the area of molars and pre-molars. It is commonly known as Sinus Augmentation in aesthetic dentistry. In more than 20% patients suffering with accidental tooth loss, often invasive sinus lift surgery is being offered, which involves separation of delicate membrane from the floor above the upper jaw and the bone is inserted to make the jawbone thicker for implantation. However, conventional sinus lift surgery is being remarked as a very unpleasant experience that takes more than an hour with significant trauma. However, modern, non-invasive technology incorporating mesenchymal stem cells derived from dental pulp tissue, growth factors and biodegradable scaffolds made from different Xeno/Allo/Synthetic Substitutes, for direct tissue reconstruction have been acknowledged to decrease wait time and increased clinical outcome. Since the introduction of the said concept of integration of biodegradable, regenerative tissue reconstruction technology and its clinical applications in modern dentistry has found to have long term success for natural restoration of tissue specific functional attributes, like smiling, chewing, etc., which have been highly appreciated. In this regard, we have adapted a multidisciplinary approach towards engineering oral tissues, in order to build complex structures like bone, teeth, as well as soft dental tissues related to the craniofacial complexities; through systemic integration of stem cells population isolated from various sources of oral cavities and their implantation back with novel applications of biocompatible scaffolds to be able to provide chemical as well as mechanical cues, thus promoting multicellular interactions, orchestrate cellular adhesion, migration and differentiation into a desired cellular lineage. Accordingly, sinus lift is generally being suggested when there is not enough bone height in the upper jaw or the sinuses are too close for dental implants to be placed; accordingly, several reasons for this indication can be:
Tooth loss, especially back teeth and molars with insufficient space for bone implants.
Bone loss, due to periodontal gum diseases
Bone resorption, due to tooth decay
Need of dental implants, when placement of maxillary sinuses is too close to the upper jaw.
Results of Sinus Lift Augmentation Through Dental Pulp Derived Stem Cells and Biodegradable Scaffolds.
Maxillary Sinus lift Augmentation through biodegradable scaffold is a novel technique and can be used to allow faster regeneration of punctured bone and speedy healing. It has been recently identified as an effective alternative to to increase bone in the posterior maxilla and hence allow faster integration of lost tooth.
This may be the reason, the kind of procedure has been acknowledged as more safe, comfortable and reliable option, over the conventional forms.
Although, sinus lift has become more common; tissue engineering with non-invasive, modern technology is attracting many people as an effective substitute over traditional, painful procedure.
Sinus lift surgeries has been identified as one of the common dental implant procedures that require sufficient training, due to its regional inherent challenges. Moreover, disease stimulated teeth loss can further accentuate bone deficiency, further complicating surgical mode of bone grafting and remodeling. Thus, in order to adapt, circumvent and treat these local physiological as well as anatomical limitations; regenerative, reconstruction of bony platform with application of regenerative medicine and modern tissue engineering technology can be emphasized for natural, tailored lifting of sinus membrane, for their functional restoration.
In this regard, the site, size and associated soft tissue defects represent the three most important factors; in determining the impact of treatment procedure on functional restoration and aesthetics.
Our process of maxillary and/or mandibular jawline reconstruction involves three key elements, which include:
Inductive soluble growth factors
Stem cells isolated from dental pulp tissue
Biocompatible scaffolds made up of Xeno/Allo/Synthetic substitutes
Accordingly, steps involved in the procedures are:
Step 1- Qualification For The Treatment
A safety and efficacy assessments will be prescribed by our experts in order to investigate a degree of severity and a need to undergo particular treatment. Following pretreatment assessments can be suggested.
Infectious Disease Testing
Medical Reports & History
Panorex X Rays
Cephalometric X Rays
Models & Impressions
As per the results, the patient will be further counselled for final treatment that will impact proper jaw functions and an aesthetic appearance of an entire face.
Step 2- Source Extraction
Mesenchymal stem cells and/or neural crest derived stem cells isolated from soft tissue of the wisdom tooth has been confirmed to be the most potent, non-invasive source of stem cells with high proliferation rate, higher degree of differentiation and a better capacity to interact with biocompatible matrices and growth factors for faster regeneration and healing.
Thus, Dental Pulp stem cells sourced from either wisdom tooth or milk tooth, that are already planned to remove will be collected as a better fitting tool due to easy access, and a very low morbidity of the anatomical site.
Step 3- Laboratory Processing
Tissue samples containing stem cells will be transported to our ultramodern GMP grade facility, through placing it, in a screw top vial containing appropriate transportation media; which may nourish it during transportation. Mesenchymal stem cells and/or neural crest derived stem cells will be isolated from a soft dental pulp tissue, which is encased inside a bony cavity of wisdom tooth or milk tooth; under controlled sterile conditions.
Step 4- Stem Cell Implantation
Expanded stem cells will be loaded on a suitable matrix called as scaffold to allow speedy attachment, faster regeneration into specific cell types and easy proliferation. Although scaffolds are of different types, shapes, patterns as well as biocompatible materials; depending upon the necessity, capacity and costing it can be made up of Xeno/Allo/Synthetic substitute.
Tissue Reconstruction through Biodegradable Scaffolds: - We have wide range of ideal scaffolds made up of different biocompatible materials, to provide chemical stability, physical strength and mimicking the surrounding tissue with respect to faster cellular proliferation, better adhesion performance, controlled degradation, easy differentiation and better integration.
A scaffold will further be implanted and secured in a position above and/or below jawline; depending upon the clinical condition to allow faster reconstruction and speedy healing of jawbones.
Step 5- Maintenance & Follow Up
Following the completion of implants, patients are advised to thoroughly clean around the implants as instructed by our dental hygienist. Patients will be called for the regular review so that the health and the integrity of the soft tissues and other bones can be evaluated.
When we lose a tooth, the body has a natural tendency to re-absorb the bone that is not being used; around that particular area. Accordingly, after some period of time the implants cannot be placed in that particular area, due to insufficient availability of bones. In this regard, sinus lift augmentation is the only possible solution. Augmentation is simply application of biodegradable scaffolds that are being offered for the regeneration of new bone structures.
What is Guided Bone Regeneration (GBR)?
Guided bone regeneration is a sophisticated technique that is being routinely used today. The procedure is generally being implemented to stabilize the endangered jawbone and to further preparing it for dental implants. During this procedure, the pockets of degenerated bones are thoroughly cleaned; and a scaffold of biodegradable material (Auto/Allo/Xeno) is being installed between the soft tissue and the pocket in the bone. These newly designed membranes donā€™t need any removal as they are bio-absorbable. The stem cells isolated from dental pulp are being re-infused on the membrane to offer them a three-dimensional microenvironment to regenerate lost or damaging tissues.
Am I a candidate for sinus lift augmentation?
A sinus lift may be necessary for you, if you are:
Missing more than one tooth, in the back of your jaw.
Missing a significant amount of your bone in the back of your jaw.
Missing teeth due to birth defect or some other congenital abnormalities.
Missing many of the maxillary teeth, but require some support for further dental implants.
How is the augmentation procedure being accomplished?
In the most commonly accepted procedure, a small incision is being made on the premolar or molar region of the jawbone; that is being treated. Through this small opening, the membrane lining the sinus is being pushed upward. The underlying space is filled with synthetic, biodegradable bone grafting scaffold, made up of Auto/Allo/Xeno substitutes. Mesenchymal stem cells, isolated from dental pulp tissue are being re-implanted on the membrane to allow directed integration into functional bone. Once the stem cells are implanted, the healing process begins. After few months of healing time, the bone becomes a part of your jaw and further implants can be inserted and stabilized in this new sinus bone.
Will I feel any procedural discomfort? Or Will it hurt during the procedure?
Since, you will be given local anesthesia; you might not feel any discomfort during the procedure. However, post treatment, slight swelling of the operated area is not unusual. Some people have reported extreme sensitivity, especially towards the cold that usually decreases within several weeks, post treatment. Further to which, this extreme sensitivity can as well be minimized by keeping the area as free of plaque as possible. Moreover, minor bleeding may occur within first 48 hours following treatment.
How stem cells therapy can be useful in undergoing Craniofacial Tissue Regeneration?
Stem cells are known to be the most potent cells in our body with the ability to retain their number back, through mitotic cell division and can undergo directed differentiation into variety of other specialized cells. Mesenchymal stem cells isolated from dental pulp tissue are found to be very helpful in guided tissue regeneration in the craniofacial cavity. However, it has as well been very apparent in different bench side studies that stem cells behavior and differentiation ability can be enhanced significantly through generation of suitable three-dimensional microenvironment. This microenvironment can be constructed through biomimetic scaffolds made up of All/Xeno/Auto substitutes in order to enhance and speed up the process of tissue reconstruction.
How long will it take to complete the treatment?
Being a very individualistic treatment, the total treatment time would obviously be dependent upon everyoneā€™s specific problem with varied severity. In general, treatment time lasts from 8 months to 12 months.
How much will the treatment cost?
Since, it is very difficult to accurately determine different treatment costs without clinically examining the patient; we would advise patients to undergo detailed consultation; wherein, we would assess the issue, through in person consultation, in order to evaluate the cost of treatment.