How long is the total treatment with combined sinus lift?

8-10 months across 3 visits: visit 1 for sinus lift + anterior implants (5-7 days), 4-6 months healing, visit 2 for posterior implants (4-5 days), 3 months healing, visit 3 for final bridge (2-3 days). Hotel and transfer arranged for each visit.

Is the sinus lift painful?

No, performed under local anaesthesia with mild sedation if you prefer. Post-op discomfort for 5-7 days managed with painkillers. Mild facial swelling typical. No nasal congestion expected. Most patients return to desk work within 5 days.

Can the anterior and posterior implants be placed in one surgery?

In some cases yes, when sinus lift uses crestal (closed) technique adding only 3-4 mm of bone height. For larger lateral (window) sinus lifts requiring 5+ mm bone augmentation, posterior implants are typically placed in a second visit after graft maturation.

What happens if the sinus graft fails?

Graft failure (incomplete bone formation) occurs in 5-10% of cases. We re-graft at no additional cost — covered under our internal warranty. Total timeline extends but eventual outcome is achievable. CBCT confirms bone maturation before posterior implant placement.

Is the cost higher than standard All-on-4®?

Yes. Combined sinus lift + All-on-4® includes the additional surgical procedures, Bio-Oss® and Bio-Gide® materials, extended healing time, and three-visit logistics. Quotation reflects total complexity. We send transparent itemised pricing in your written treatment plan.

All-on-4® with Sinus Lift Combined Treatment

Q: Are there alternatives to combined sinus lift?

Yes. Zygomatic implants anchor in cheekbone instead of upper jaw bone — bypasses bone deficiency entirely, single visit possible. All-on-6® with shorter posterior implants sometimes works without major sinus lift. Traditional implant-retained denture uses fewer implants. We discuss all options based on your CBCT.

Some All-on-4® candidates have insufficient upper jaw bone in the posterior region — particularly after long-standing molar tooth loss when the maxillary sinus has expanded downward. Standard All-on-4® positions implants angled away from the sinus to use available anterior bone, but in some cases additional sinus lift surgery is required for adequate stability. This combined approach is more complex than standard All-on-4® but delivers fixed-bridge restoration to patients who would otherwise require traditional dentures.

When Combined All-on-4® + Sinus Lift Is Needed

CBCT scan reveals upper jaw anatomy. Combined approach considered when:

Posterior maxillary bone height under 4-5 mm in the area where rear angled All-on-4® implants would be placed

Sinus floor has dropped significantly after years of upper molar absence

Anterior maxillary bone is also reduced (cannot rely solely on front-jaw implants)

Patient cannot tolerate traditional dentures and All-on-4® is the preferred reconstruction

For some patients, the combined approach is the only path to fixed implant-supported restoration in the upper jaw without alternative options like zygomatic implants.

The Combined Surgical Protocol

Phase 1: Sinus Lift + Anterior Implants (Visit 1, 5-7 days)

Day 1: Detailed CBCT planning, digital surgical guide preparation

Day 2: Lateral sinus lift on both sides (window approach, Bio-Oss® bone graft, Bio-Gide® membrane)

Day 2: Same day, 2-3 anterior implants placed in available pre-maxillary bone

Days 3-5: Recovery, swelling management, soft diet

Day 6-7: Stitch check, fly home with healing covered

Healing Window (4-6 months):

Sinus graft heals and bone matures

Anterior implants integrate

Patient wears temporary partial denture during healing (or maintains existing prosthesis)

Phase 2: Posterior Implants in Grafted Bone (Visit 2, 4-5 days)

Day 1: New CBCT to confirm bone maturation in sinus areas

Day 2: 2 posterior implants placed in newly grafted bone

Day 3: Same-day temporary bridge connecting all 4 implants

Days 4-5: Recovery, fly home with All-on-4® temporary in place

Healing Window (3 months):

Posterior implants integrate

Temporary bridge functions

Phase 3: Final Permanent Bridge (Visit 3, 2-3 days)

Day 1: Final impression of all 4 integrated implants

Day 2: Master ceramist fabricates final monolithic zirconia bridge

Day 3: Final bridge placement, bite adjustment, final result

Total elapsed time: 8-10 months across 3 visits.

Why Three Visits

The biological timeline requires:

4-6 months for sinus graft to mature into placeable bone

3 months for posterior implants to integrate after placement in grafted bone

Cannot be safely compressed without compromising long-term success

For patients in a hurry, alternatives exist:

Zygomatic implants anchored in cheekbone instead of upper jaw — bypasses bone deficiency entirely. Specialised technique, single visit possible.

All-on-6® with shorter posterior implants — sometimes feasible without major sinus lift.

Traditional implant-retained denture — fewer implants, less surgical complexity.

CBCT-based planning identifies which approach suits your specific anatomy.

Materials and Brands Used

Bone graft material: Bio-Oss® (Geistlich, Switzerland) — gold-standard bovine-derived bone matrix with extensive clinical research base.

Membrane: Bio-Gide® (Geistlich, Switzerland) — resorbable collagen barrier preventing soft tissue invasion of graft area.

Implants: Straumann SLActive® preferred for grafted bone integration speed. Nobel Biocare TiUltra® for All-on-4® original protocol.

Final bridge: Prettau Zirconia (Zirkonzahn, Italy) monolithic for maximum strength on cantilevered bridge design.

Risk Profile and Honest Discussion

Combined sinus lift + All-on-4® has higher surgical complexity than either procedure alone:

Sinus membrane perforation risk during lift (5-15% incidence; managed at the time)

Sinus infection risk post-graft (1-3%; antibiotic prophylaxis mitigates)

Posterior implant failure in grafted bone (5-8% vs 2-4% in native bone)

Total treatment timeline 8-10 months — patience required

WeCare discusses these risks honestly during planning. Some patients choose alternatives (zygomatic implants, dentures) after understanding the timeline.

Who Performs This Combined Case

At WeCare, combined sinus lift + All-on-4® is performed by Dr. Mehmet Yılmaz personally, due to the surgical complexity. He has performed approximately 80 combined cases over the past 5 years, with documented 92-95% long-term success.

What to Send Us

WhatsApp +90 551 086 83 68 with:

Recent panoramic X-ray (OPG)

Recent CBCT scan if available (mandatory for this case type)

Medical history and medications

Smoking status (combined surgery requires strict cessation)

HbA1c if diabetic

Specific concerns or prior failed treatment history

Within 48-72 hours (case complexity warrants longer review) we send written assessment of whether this approach is right for you, alternatives if more appropriate, full timeline, and individual quotation.

All-on-4® with Sinus Lift — Combined Surgical Approach