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El cirujano puede rechazar al paciente en el elevador de seno, si tiene problemas de salud. Convencionalmente, contraindicaciones para la cirugía se dividen en dos grupos: absolutos y relativos.

Contraindicaciones absolutas

Se trata de afecciones que dificultan las manipulaciones quirúrgicas o reducen repetidamente las posibilidades de injerto del implante. La cirugía no es posible en:

  • mental disorders,
  • severe heart disease,
  • cancer,
  • tuberculosis,
  • blood clotting disorders,
  • autoimmune diseases (lupus erythematosus, rheumatoid arthritis, multiple sclerosis),
  • pregnancy.

Relative contraindications

Pueden eliminarse o corregirse fácilmente en el momento de la colocación del implante. La decisión de operar la toma el cirujano tras un diagnóstico exhaustivo del paciente y la consulta con médicos subespecializados.

Las contraindicaciones relativas incluyen:

  • diabetes mellitus (the operation will be done after the endocrinologist selects the correct treatment),
  • angina pectoris (the intervention is performed in remission),
  • rhinitis, acute or chronic sinusitis (the patient will be referred to an ENT specialist for treatment),
  • cysts, purulent processes in the oral cavity, tooth decay and gum disease (treated by a general dentist).

With caution, surgical intervention is performed on smokers, as they have worse healing of tissues. The risk of implant rejection is reduced if the patient stops smoking at least 2 weeks before surgery.

A contraindication to closed sinus elevator is a bone height of less than 5-6 mm.

How safe is a sinus elevator

Any surgical procedure is a health risk. A common complication of a sinus elevator is rupture of the maxillary sinus walls. The doctor can damage them while moving the bottom of the sinus upward. If this happens, the surgeon sutures the tear and completes the sinus elevator surgery. But if the tear is too large, the procedure has to be interrupted. It is attempted again six months later, when the sinus wall has healed.

Other complications:

  • infection of the bone substitute,
  • bleeding,
  • exacerbation of chronic inflammation of the maxillary sinus.

The risks of complications are higher in smokers, diabetics, and patients with immune disorders.

Alternatives

An alternative to sinus elevator is the placement of removable prostheses (burettes or plates) or basal implantation. Unlike classical implants, basal implants bypass the maxillary sinuses. They are placed in the deep layers of the jaw, which do not resorb over time. Therefore, the procedure is performed without prior bone augmentation. The only disadvantage of basal implantation is that it is used only in the absence of 3 or more consecutive teeth.

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