Can all on 4 implants be done without a sinus lift?

Question

Lance Timmerman, DMD, MAGD · Answer

All on four was developed as a "graftless method" to reconstruct an arch with dental implants.  In years past, it was taught that the upper arch needed 8-10 implants and the lower arch needed 6-8 implants when reconstructing with dental implants and that the implants needed to be perpendicular to the bite forces (no tilting). This usually required bone grafting, including sinus lifts, in order to have enough bone to place so many implants in the "correct" locations.

Tilting implants and only having 4 was originally viewed as below standard of care, but is now viewed as normal or common.

David R. Kirkpatrick, DMD, FACS · Answer

You can place a full set or upper set of implant-supported teeth without sinus lifts or bone grafting using zygomatic implants. Thanks to modern research leading to the advancement of zygomatic dental implants, patients who have been told they are not candidates for conventional dental implants, can be treated successfully. Designed specifically for patients with bone loss, zygomatic implants are tilted and much longer than traditional dental implants. While traditional implants are placed in the jawbone, zygomatic dental implants are placed in the cheekbone which is very dense and provides excellent support.

Dan Holtzclaw, DDS, MS · Answer

Traditionally, All-On-4 dental implant procedures allow patients to avoid sinus lift surgery.  With this style of treatment, the implants farthest back in the mouth are typically angled forward up to 45 degrees.  Placing the back implants in this manner avoids the sinus and allows longer implants to be placed that provide an increased amount of bone-to-implant contact.  
With that being said, in certain situations, sinus lifts may be required for All-On-4 style dental implant surgery.  In some patients, the sinuses have enlarged so much, that there is not enough bone remaining to allow for All-On-4 procedures.  In such circumstances, sinus lifts may be required to allow for dental implant placement.  An alternative to sinus lifts in these situations is sometimes a zygomatic dental implant, but these implants have their own inherent issues.  
In performing over 1,000 All-On-4 style dental implant procedures, I have only "had" to do sinus lifts in less than 4% of cases.  Essentially, most All-On-4 style cases can be done without sinus lift surgery.

John Paul Gallardo, DDS · Answer

The concept of the All-on-4 was based on a graft-less procedure where no bone grafting is to be incorporated. Although I use bone grafting as necessary, especially in areas where teeth are extracted, the basis of the angling techniques of the implants is intentionally done in order to avoid the sinus and the necessary grafting in otherwise conventional techniques.

Juan C. Arroyo, DMD · Answer

Hi and thank you for your question.
One of the reasons for doing an All on Four is to avoid doing surgery in the sinuses, but in some situations there is so much bone loss that to be able to do an All on Four you need to do sinus lifts. Get evaluated by an office that has 3D imaging (CBCT) , I suggest an Oral & Maxillofacial Surgeon's office. I have done many of those cases and although they take a bit longer, to the patients is is well worth it. Good luck to you, I hope you get your Dream Smile!
Dr. Juan C. Arroyo
Oral & Maxillofacial Surgeon

Can all on 4 implants be done without a sinus lift?

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Answer: All-on-4 Without Sinus Lift

Answer: All-on-4 Without Sinus Lift

Answer: All On Four without sinus Lifts

Answer: All On Four without sinus Lifts

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Can all on 4 implants be done without a sinus lift?

Answers (7)

Answer: All-on-4 Without Sinus Lift

Answer: All-on-4 Without Sinus Lift

Answer: All On Four without sinus Lifts

Answer: All On Four without sinus Lifts

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Everything you need to know about All-on-4 Dental Implants

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