When upper teeth have been missing for an extended period, bone resorption is often unavoidable—creating a major challenge for implant rehabilitation. Closed sinus lift has emerged as an effective “rescue” technique, helping restore bone height safely and predictably, and supporting a strong, stable bite with dental implants.

Are you exploring dental implants and wondering whether your upper jawbone is sufficient for treatment? Especially if you have been missing teeth for many years, bone loss can be a real concern. However, don’t rule out the possibility of restoring a complete smile—closed sinus lift is an advanced technique widely performed at reputable dental centers to help make implant placement possible. In this article, we’ll take an in-depth look at a real clinical case, so you can better understand the procedure, its benefits, and the results this technique can achieve.

What is Close Sinus Lift?

Closed sinus lift—also known as the internal (crestal) maxillary sinus floor elevation—is a refined dental procedure. Instead of creating a large lateral “window” to access the sinus, the clinician works through the prepared implant osteotomy site. The goal is to gently elevate the sinus floor by a controlled amount (typically 2–4 mm), creating a small space beneath the sinus membrane. This space is then filled with bone graft material to stimulate the body’s natural bone regeneration process.

• This technique is particularly suitable when there is still a moderate amount of residual upper jawbone—typically around 4–5 mm in height—yet it remains insufficient to achieve stable, predictable implant placement.
• It is ideal for patients who still have about 4–5 mm of remaining upper jawbone, but not enough to support an implant securely without additional bone elevation.

When Should You Choose a Closed Sinus Lift? Indications and Contraindications

Not every case is suitable for a closed sinus lift. Your dentist will evaluate your bone condition and overall health to determine whether this technique is appropriate for you.

Indications:

• Prolonged loss of posterior upper teeth can lead to alveolar bone resorption and sinus floor pneumatization, yet residual bone height may still fall within the 4–8 mm range.
• The patient wishes to restore missing teeth with dental implants and aims to minimize the number of surgical procedures.
• It is important to note that a residual bone height of 8 mm or greater is generally considered ideal for achieving stable implant placement. With sinus elevation, the clinician can typically gain an additional 2–3 mm of vertical bone height by gently elevating the sinus (Schneiderian) membrane, supporting secure implant anchorage.

Contraindications:

• Residual bone height < 4 mm: In this situation, a lateral (open) sinus lift, with a larger access window, may be the more appropriate alternative.
• Untreated sinus pathology: Conditions such as chronic sinusitis or sinus polyps should be treated and ruled out prior to the procedure.
• Bleeding disorders or systemic conditions that are poorly controlled.
• Heavy smoking or inadequate oral hygiene, which may compromise healing and overall outcomes.

Advantages and Key Limitations of Closed Sinus Lift You Should Know

Choosing a closed sinus lift technique can offer several meaningful benefits for patients:

Advantages:

• A minimally invasive approach that does not require a lateral sinus window, helping reduce surgical trauma.
• A lower risk of complications such as sinus membrane perforation, with less postoperative swelling, pain, and discomfort.
• Shorter overall treatment time, as implants can often be placed immediately.
• Faster recovery and a quicker return to normal daily activities.

Disadvantages:

• It is only effective when residual bone height is at least 4–5 mm.
• The procedure requires a highly skilled clinician with strong control and precision to perform it safely and accurately.

How Does Healing Progress After a Closed Sinus Lift?

After the sinus membrane is elevated and bone graft material is placed, the body begins a natural healing and regeneration process:

• The space created between the sinus membrane and the bony floor is initially filled with the graft material and a stabilizing blood clot.
• Over the next 4–6 months, new bone gradually forms and matures around the graft, replacing it over time and filling the elevated area.
• In parallel, the dental implant (if placed) progressively integrates with the developing bone.
• At approximately 5–6 months, once the bone has reached sufficient stability, the clinician proceeds with the final prosthetic restoration (a crown) on the implant.

Real Clinical Case at Herident: A Successful Closed Sinus Lift for Ms. T.

Ms. T., 41, came to Herident seeking to address the long-standing loss of tooth #26 (the upper left first molar). The absence of this tooth had not only significantly affected her chewing efficiency, but also contributed to an overall imbalance in her bite.

Concerned about jawbone condition and seeking long-term implant stability

Ms. T. expressed her wish to replace the missing tooth with a dental implant to restore long-term chewing function and aesthetics. However, she was understandably concerned that the upper jawbone had already undergone significant resorption and questioned whether there was enough bone to support an implant. She also felt apprehensive about the complexity of sinus elevation and its potential impact on her overall health.

Accurate diagnosis by Herident specialists

• Following a thorough clinical examination, the implant specialist at Herident recommended a 3D Cone Beam CT scan. The findings showed:
• Tooth #26 had been missing for an extended period, resulting in significant alveolar bone resorption.
• Residual bone height at the edentulous site was approximately 5.3 mm, which is below the threshold for safe, predictable implant placement.
• The maxillary sinus floor had pneumatized (descended), increasing the risk of sinus involvement if an implant were placed directly without augmentation.

Based on these results, the clinician concluded that Ms. T. was a suitable candidate for a closed sinus lift combined with dental implant placement.

Optimal Treatment Plan

The clinician proposed a detailed treatment plan for Ms. T.: performing a closed sinus lift, placing bone graft material, and inserting a Korean-made dental implant in the same surgical appointment. This approach offers a dual benefit—minimizing invasiveness while accelerating healing—and often enables immediate implant placement when primary stability can be achieved.

Procedure

Preparation: Ms. T. underwent a general health assessment, professional oral hygiene, and a detailed consultation regarding the procedure and implant materials.

• Closed sinus lift procedure: Performed by an experienced clinician, the maxillary sinus floor was gently elevated by approximately 3–4 mm through the implant osteotomy.
• Bone grafting: Bone graft material was placed into the newly created space, providing a stable scaffold for new bone formation.
• Implant placement: A Korean-made dental implant was inserted securely into the prepared site.
• Follow-up and review visits: Ms. T. received postoperative care instructions, prescribed medications, and scheduled follow-up appointments to monitor healing and osseointegration.

Result 

After five months of healing, the implant demonstrated successful osseointegration. Ms. T. returned to Herident to proceed with the final restoration—a dental crown placed on the implant.

• Chewing function: Ms. T. was fully satisfied with the stable bite and reported no longer experiencing any imbalance or discomfort while chewing.
• Aesthetics: The implant crown achieved a natural shade and contour, harmonizing well with adjacent teeth and enhancing her smile.
• Radiographic outcome: Follow-up imaging showed a stable implant with dense, healthy peri-implant bone and no signs of crestal bone loss.
• Patient feedback: Ms. T. shared that she felt confident and reassured, with no ongoing concerns about bone volume or sinus health.

Expert Advice from Herident Specialists

Ms. T.’s case is a clear example of how effective a closed sinus lift can be in supporting implant placement in the upper jaw. When residual bone height is in the range of approximately 6–8 mm, this approach may be an optimal option—safe, efficient, and time-saving.

A 3D Cone Beam CT scan is an essential step, allowing the clinician to accurately assess bone volume, sinus anatomy, and develop a precise, individualized treatment plan.

Medical-grade bone graft materials also play a key role, providing a stable scaffold for bone regeneration, supporting implant stability, and helping maintain long-term outcomes.

At Herident, we are committed to delivering implant care to the highest clinical standards, with a focus on transparency and patient safety:

• Authentic implant systems with clear certification and documentation.
• Dedicated implant clinicians with advanced training and extensive experience.
• Transparent implant agreements outlining costs, warranty terms, and long-term maintenance benefits.

The patient smiling alongside the dentist at Herident Dental Clinic.

Herident is proud to be a specialized center for orthodontics, ceramic restorations, and dental implant therapy—providing comprehensive solutions for every aspect of your oral health. If you are experiencing bone loss or have any concerns about dental implants, we invite you to contact us for a thorough consultation and detailed clinical assessment.