Post-Op Sinus Lift
A window was created in the side of your upper jaw (Maxilla), and the thin membrane lining the sinus was lifted up, the implant (s) act like a tent pole, and the bone graft is packed around it.
For the first 7 days, avoid blowing your nose hard – it can tear the membrane and displace the bone graft. This is very important. You may sniff all you like but no nose blowing. Do not blow your nose or sneeze holding your nose. Sneeze with your mouth open. Anything that causes pressure in your nasal cavity must be avoided. Scuba diving may also increase sinus pressure and should be avoided for 4 weeks. Decongestants such as Drixoral, Dimetapp®, or Sudafed® will help reduce pressure in the sinuses. Avoid bearing down as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure. Smoking must be stopped. If necessary Dr. Loetscher or Dr. Cho can prescribe NicoDerm patches.
Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 60 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) can be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas. Always use the softest toothbrush you can buy.
Food to Avoid
Avoid abrasive foods, such as crusty breads, bagels, sharp chips, etc. in this area for about 8 days. These can break down the incision lines.
Straws are OK to use, unless tooth extractions sites exist elsewhere in the mouth (if so – avoid straws for 3 days).
The cheek on that side of your face will swell, with the peak swelling 2-3 days later. You may apply ice or cold compresses to this area to ease the swelling. Frozen pea bags with a towel wrapped around them work well.
The sutures usually are two types – chromic gut which dissolve on their own in 10-14 days, and Vicryl – which dissolve in 2-3 months. We usually remove the undissolved Vicryl sutures at your 2-3 week post-op appointment.
If BMP (bone morphogenic protein) was used as part or all of your bone graft – you often get a second phase of swelling at about day 6, lasting for about 2 days. This can be alarming because your cheek may become red, and your lower eyelid may have some slight swelling (edema). This is normal and actually how the BMP works – by drawing in stem cells.
If your lower jaw or hip were used to obtain your bone graft – you usually have a 10 day post-op course of antibiotics. If BMP was used, it typically is a 7 day course of antibiotics.
There may be some bleeding from your nose off and on for the first 2-3 days. Sometimes a blood clot will form in the sinus, and break down sometime in the first week, and cause a big drainage for about a half an hour, and then stop. Any prolonged bright red bleeding is not normal, and our office should be contacted.
Wearing Prosthesis or Night Guards
Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. Please contact the office if there is any question. If you have a temporary flipper to wear do not place it until the numbness in the area is gone. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until your general dentist or our office can see you.
The bone graft particles around your implants need to consolidate and form a callus. Therefore, for 6 days you should avoid exercise that may displace these particles, such as running, playing tennis, and other sports where there are jolting type motions. In addition, for 4 days, you should avoid exercising where your blood pressure becomes elevated, or your heart rate above 120, as this could cause some excessive bleeding, and possible formation of a hematoma. A hematoma is a collection or “lump” of blood. These can cause bleeding or even become infected.