In this answer
Why a single implant sometimes needs one
When you replace one upper back tooth, the implant has to go exactly where that tooth was. If there isn't enough bone between the gum and the sinus above it, there's nothing solid to hold it. A sinus lift builds bone in that spot so the implant can go where the tooth needs to be.
That's a real fix for a real problem. If you're replacing one molar, your dentist may well be right.
Why full-arch is different
A full arch doesn't need an implant under every tooth. Four to six implants carry the whole arch, and we can place them at an angle instead of straight up and down.
The angle gives each implant more bone to grip, which makes the support stronger. It also lets us place the implant in front of the sinus instead of under it.
So the problem that calls for a sinus lift with a single tooth mostly goes away when we plan around the whole arch.
What our records show
Over the same period we did sinus lifts for a number of patients, and nearly all of them were single-implant cases. It's a common procedure for single teeth and rarely needed for a full arch.
Angled implants and straight implants
Implants that failed
Upper-jaw studies only: angled implants failed 1.70 times as often (range 1.05 to 2.74).
Across 44 published papers, angled implants failed about as often as straight ones. One caveat: in the upper-jaw studies alone, angled implants did fail more often, at 1.70 times the rate.
5,029 angled and 5,732 straight implants from 44 papers. Some papers sorted people at random and some only watched what happened. Overall, the difference was too small to be sure of. The upper-jaw result (1.70 times, range 1.05 to 2.74) matters for this page, which is about the upper jaw. The authors say bias and hidden differences between groups limit the results. A 2018 review of 42 articles also found no differences, and gives no added-up figures.
- Chrcanovic BR, Albrektsson T, Wennerberg A. Tilted versus axially placed dental implants: a meta-analysis. J Dent. 2015;43(2):149-70. doi:10.1016/j.jdent.2014.09.002. PMID 25239770.
- Lin WS, Eckert SE. Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review. Clin Oral Implants Res. 2018;29 Suppl 16:78-105. doi:10.1111/clr.13294. PMID 30328193.
Most importantly I felt that I was finally being listened to with my dental concerns.
Two dentists, two opinions
Two dentists can look at the same X-ray and reach different answers without either being dishonest. They're often planning different treatments. Replacing single teeth and building a full arch are different jobs.
So ask what are you planning to build, and how many implants does it need? The sinus question follows from that.
When we decide
If your full-arch case needs a sinus lift, we'll know before surgery, from your scan, while we plan. It won't be something found on the day and added to your bill.
Quick answers
Will a sinus lift add to what I pay?
If you need one, we'll tell you at your consultation, before anything is scheduled, along with what it changes. It depends on your scan and it's rare in full-arch cases, so there's no figure on this page. You'll have it in writing before you decide anything.
Does a sinus lift make recovery longer?
It can change both the timeline and the healing. If it applies to you, we'll explain that at your consultation so you know what to expect before you commit. Most full-arch patients never need one.
My scan shows very little upper bone. Am I still a candidate?
Usually, yes. Very little upper bone is common after years in an upper denture, and full-arch treatment is designed around it. We angle the implants to use the bone you have, and there are other options if that isn't enough. Your scan tells us which applies, and we'll go over what it means for your timeline and healing before you decide.
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What is periodontal disease, and why does it lead to full-arch implants?
Periodontal disease is an imbalance in the mouth's bacteria that goes on for years. Slowly it breaks down the bone, inflames the gums, and loosens teeth until they're lost. It's the most common road to full-arch treatment. Most people who need a full arch got here after years of gum disease that was never treated or never stayed under control.
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Read the full answerCan I get dental implants if I have diabetes?
Yes. And it's one of the few risk factors you can improve before surgery. What matters is whether your diabetes is under control. An A1C between six and seven is a very different picture from an A1C of nine. If yours is high, we'd rather work with your doctor first than rush you into surgery.
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