Why it is needed

The upper back jaw sits below the maxillary sinus.² The AAP states this area is difficult for implants because of limited bone quantity and quality and the closeness of the sinus.¹ AAOMS states that losing back teeth in the upper jaw leads to bone thinning, and the sinus expands downward into the space.²

A sinus lift (sinus augmentation, sinus floor elevation) raises the sinus membrane and places bone graft material underneath to add bone height.¹

Two approaches

AAOMS describes two techniques.²

Lateral window. The gum is opened, a small window is made in the side of the jawbone, the sinus membrane is lifted and graft material fills the space.²
Vertical osteotome (transalveolar or crestal). A small hole is made in the jawbone below the sinus, and the membrane is lifted from below through the implant site.²

The graft may be synthetic, animal-derived or the patient's own bone.²

Timing

The AAP states the graft usually develops for 4 to 12 months before implants are placed.¹ In some cases the implant is placed at the same time as the sinus lift.¹

Results

Approach	Implants studied	3-year implant survival
Sinus floor elevation, 48 studies	12,020	90.1 percent³
Rough-surface implants, membrane over the window		98.3 percent³
Transalveolar (crestal)	4,388	92.8 percent⁴

For the transalveolar approach, membrane perforation was reported in 3.8 percent of patients and infection in 0.8 percent.⁴ It was most predictable when at least 5 mm of bone height remained and the sinus floor was relatively flat.⁴ More than nine in ten patients who had the transalveolar procedure said they would undergo it again.⁴

Alternatives

A 2026 meta-analysis of 8 randomized trials found no difference in implant failure between short implants (8 mm or less) and standard implants placed with a sinus lift.⁵ Where upper-jaw bone loss is severe, zygomatic implants anchor in the cheekbone instead.⁶ Pterygoid implants are covered in their own topic.

General information about dental implants. Treatment decisions are made with a licensed dentist.

Sources

American Academy of Periodontology: Sinus Augmentation. perio.org
AAOMS (MyOMS.org): Sinus Augmentation. myoms.org
Pjetursson BE et al. Systematic review of sinus floor elevation and implant survival. J Clin Periodontol 2008. pubmed.ncbi.nlm.nih.gov
Pjetursson BE, Lang NP. Sinus floor elevation utilizing the transalveolar approach. Periodontol 2000 2014. pubmed.ncbi.nlm.nih.gov
Wang C et al. Short implants vs standard implants with sinus floor elevation: systematic review of RCTs. J Stomatol Oral Maxillofac Surg 2026. pubmed.ncbi.nlm.nih.gov
Visconti RF et al. Zygomatic implants for the severely atrophic edentulous maxilla. Cochrane Database Syst Rev 2026. pubmed.ncbi.nlm.nih.gov

Evidence

Sourced facts

Each line links to the study or the specialty body it comes from.

The AAP states that the upper back jaw often has insufficient bone because of its closeness to the sinus and bone loss after tooth loss.

American Academy of Periodontology: Sinus Augmentation · checked October 2, 2026
AAOMS describes two approaches: a lateral window through the side of the jawbone, and a vertical osteotome approach through a small hole below the sinus.

AAOMS (MyOMS.org): Sinus Augmentation · checked October 2, 2026
The AAP states the graft usually develops for 4 to 12 months before implants, and in some cases the implant is placed at the same time.

American Academy of Periodontology: Sinus Augmentation · checked October 2, 2026
A systematic review of 48 studies and 12,020 implants found 3-year implant survival of 90.1 percent with sinus floor elevation; rough-surface implants with membrane coverage reached 98.3 percent.

Pjetursson BE et al. Systematic review of sinus floor elevation and implant survival. J Clin Periodontol 2008 · checked October 2, 2026
For the transalveolar (crestal) approach, a review reported 92.8 percent 3-year implant survival across 4,388 implants, membrane perforation in 3.8 percent and infection in 0.8 percent.

Pjetursson BE, Lang NP. Sinus floor elevation utilizing the transalveolar approach. Periodontol 2000 2014 · checked October 2, 2026
The transalveolar approach was most predictable when residual bone height was 5 mm or more.

Pjetursson BE, Lang NP. Sinus floor elevation utilizing the transalveolar approach. Periodontol 2000 2014 · checked October 2, 2026
A 2026 meta-analysis of 8 randomized trials found no difference in failure between short implants (8 mm or less) and standard implants with sinus lift.

Wang C et al. Short implants vs standard implants with sinus floor elevation: systematic review of RCTs. J Stomatol Oral Maxillofac Surg 2026 · checked October 2, 2026
A 2026 Cochrane review describes zygomatic implants as anchoring in the cheekbone, an alternative to bone augmentation in severe upper-jaw bone loss.

Visconti RF et al. Zygomatic implants for the severely atrophic edentulous maxilla. Cochrane Database Syst Rev 2026 · checked October 2, 2026

Related topics

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Procedures

Bone grafting for implants

Bone grafting adds bone or bone substitute where the jaw is too thin or short for an implant. Grafts come from the patient, a human donor, an animal source, or synthetic material.

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Procedures

Short implants

Short implants (6 to 8 mm or less) are used where bone height is limited, sometimes in place of a sinus lift or vertical graft. Survival is close to standard implants, with more variability for the shortest designs.

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Procedures

Zygomatic implants

Zygomatic implants are long implants anchored in the cheekbone, used when the upper jaw has too little bone for standard implants. They can avoid bone grafting and allow teeth soon after surgery, with a higher complication rate.

Procedures

Pterygoid implants

Pterygoid implants are placed in the pterygoid region at the back of the upper jaw. In the published series they mainly support full-arch fixed bridges, with 6-year survival similar to implants elsewhere in the jaws.