Open and closed sinus lift: how they differ, which is chosen, and what it costs in Astana

Key points

• The maxillary sinus sits above the upper molars. After those teeth are extracted, the bone between the sinus and the mouth thins to 2–4 mm, while an implant needs 8–10 mm. A sinus lift raises the floor of the sinus and fills the space with bone material.
• Closed: through the socket for the implant, no incision on the side, used when only 2–3 mm are missing; the implant goes in during the same surgery. 200,000 ₸.
• Open: through a small window in the side wall, used when there is very little bone; healing takes 4–6 months before the implant. 300,000–450,000 ₸ depending on how many teeth are involved.
• A sinus lift can sometimes be avoided: tilted implants (All-on-4), short implants, or anchoring in the pterygoid bone — as was done in the clinic's case.
• The surgery is done under local anaesthesia and feels like an extraction; the main restriction afterwards is 2 weeks of no nose-blowing, diving, or flying.

Why this is needed

The roots of the upper molars nearly touch the floor of the maxillary sinus. Once a tooth is extracted, the bone there stops carrying any load and shrinks, while the sinus, in turn, expands downward. Within a year or two, only a thin plate of bone — 2–5 mm — is left between the sinus and the gum. An 8–10 mm implant cannot go there: it would protrude into the sinus.

A sinus lift solves this: the sinus membrane is carefully raised, and bone material is placed underneath it. Within a few months it turns into the patient's own bone, and the implant can be placed into a full volume of it.

Closed sinus lift

Done through the opening drilled for the implant. The sinus floor is raised 2–4 mm with special instruments, bone material is introduced, and the implant is placed right away. There is no incision on the side.

When: if there is 5–7 mm of the patient's own bone and only a little more is needed.

Advantages: one operation, the implant goes in immediately, and healing is the same as with ordinary implant placement.

Disadvantages: only a small lift is possible; the surgeon works 'blind,' guided by feel and the scan.

Price: 200,000 ₸ plus the implant.

Open sinus lift

A small window is made in the side wall of the upper jaw, through which the sinus membrane is lifted and the space is filled with as much bone material as needed — even 8–10 mm. The window is closed with a membrane (60,000–80,000 ₸).

When: if there is less than 4–5 mm of the patient's own bone, or a large lift is needed under several implants.

Advantages: control — the surgeon can see what they are doing; a large lift is possible.

Disadvantages: a second surgery for the implants 4–6 months later (if there is very little bone); more swelling and a longer recovery.

Price: 300,000 ₸ for one tooth site, 400,000 for two to three, 450,000 for four to five.

In the clinic's case, a bilateral open sinus lift was part of a larger treatment: five months, sixteen implants, twenty-nine zirconia crowns.

When a sinus lift is not needed

A bone shortfall near the sinus can sometimes be worked around, if the situation allows:

Tilted implants — with a full clearance (All-on-4/5), the back implants are placed at an angle, in front of the sinus.

Short implants (6–8 mm) — if there is 6–7 mm of bone and it is dense.

Anchoring in the pterygoid bone — the implant is placed into the dense bone behind the sinus; this is what was done in the clinic's case with loose bridges, avoiding the need for a sinus lift.

The surgeon decides based on a CBCT scan: bone height, density, and the state of the sinus (with chronic sinusitis, a sinus lift is postponed until an ENT specialist treats it).

How it goes and what comes after

Under local anaesthesia, 40–90 minutes. It feels like a tooth extraction: pressure, not pain. Afterwards: 2–3 days of swelling, possibly slight bruising; a prescribed pain reliever and antibiotic.

The main restrictions for 2 weeks cover anything that creates pressure in the sinus:

no nose-blowing (with a runny nose, use drops, and sneeze with your mouth open);

no diving, flying, blowing up balloons, or drinking through a straw;

no smoking.

A small amount of nosebleed in the first few days is normal. Congestion that does not clear within a week, or discharge with an odour, is a reason to be seen.

What it costs together with the implant

Example: one upper molar, 4 mm of bone — an open sinus lift 300,000 ₸ + membrane 60,000 + an Izen implant 80,000 five months later + a crown from 90,000 ≈ 530,000 ₸. The same tooth with 6 mm of bone — a closed lift 200,000 + the implant in the same surgery 80,000 + a crown ≈ 370,000 ₸. The consultation is free, a CBCT scan is 11,000 ₸. Instalments with Kaspi Red 0-0-24 or Halyk 0-0-12.

Related services and guides

• Sinus lift in Astana
• Bone grafting in Astana
• Dental implants in Astana

Frequently asked questions

Does it hurt?

Not under anaesthesia. Afterwards it feels like after an extraction — 2–3 days on a pain reliever.

Is it risky for the sinus?

A complication is a tear in the membrane during surgery; it is closed with a membrane, and the operation usually continues as planned. Sinusitis afterwards is rare if the restrictions are followed.

How long until the implant?

With a closed lift, the implant goes in immediately. With an open lift, 4–6 months, sometimes at the same time if there is enough bone for primary stability.

Can both sides be done at once?

Yes, a bilateral sinus lift is done in a single operation — as in the clinic's case.