Swelling after sinus lift and bone grafting

Normal or pathological Associated symptoms When not to worry Sign of complication Warning at the Center How to remove at home Pathological process Solving the problem Frequently asked questions

Swelling after sinus lift and bone grafting can be due to both the body’s natural response to tissue damage and complications. In our Center, the possibility of developing complications is minimized. We have eliminated possible risks at every stage - from preparation to rehabilitation. The use of high-tech equipment allows bone augmentation operations to be performed safely, with minimal trauma.

Swelling after surgery - normal or pathological?

Sinus lifting and other types of bone grafting are considered low-traumatic procedures performed by an experienced doctor. But in any case, this is not only a therapeutic procedure, but also a kind of trauma. As with any other surgical procedure, tissue damage is inevitable. After surgery, swelling develops, which is a physiological reaction of the body's defense systems.

Osteoplastic surgeries vary in complexity and extent of damage to the soft and bone tissues of the oral cavity:

With an open sinus lift, incisions are made in the gums on the front side of the upper jaw to create access to the maxillary sinus, requiring sutures at the final stage of surgery.
Closed sinus lifting is also accompanied by a violation of tissue integrity, since access to the bottom of the maxillary sinus is made by creating a hole in the gum and bone at the site of implant installation.
Implantation of an implant during simultaneous implantation and sinus lift operations also provokes swelling as a protective reaction to a new object for the body.
Other methods of bone grafting are carried out in various ways, but in any case they cannot be done without soft tissue incisions. Some outdated methods involve transplanting an autograft from one point of the jaw to the required area; we do not use such methods.

The severity of edema depends on the extent of the operation performed and the individual characteristics of the body . For example, women are more prone to puffiness than men. Typically, swelling is not a complication; during the normal course of the rehabilitation period it gradually decreases.

Our work is aimed at minimizing complications

We took the necessary measures at every stage - from preliminary preparation and implementation of low-traumatic protocols to a complex of proprietary rehabilitation.

Levin Dmitry Valerievich

Founder and Chief Doctor of the Center

What else do patients ask about after implantation?

Since the installation of implants is a surgical operation, people are interested in many questions about the rehabilitation period.

Does it hurt to remove stitches? The procedure is carried out after the wound has healed, so removing thin threads does not cause pain. If the patient experiences severe fear, the doctor may treat the suture area with an anesthetic gel or spray.
Why is smoking prohibited after implantation? Nicotine constricts blood vessels, slows down metabolic processes, and impairs tissue nutrition. This negatively affects wound healing and implant healing. If the patient cannot quit smoking for a long time, the doctor has the right to refuse surgery.
Why is Dexamethasone prescribed after implantation? The drug can be used as a powerful pain reliever. If the risk of inflammation is very high, then Dexamethasone is prescribed along with antibiotics. The drug quickly stops inflammatory processes and alleviates acute symptoms.
How long does a tooth hurt after implant placement? Painful sensations persist for 3 - 5 days. If the pain is severe, you can take painkillers.

Associated symptoms

In addition to swelling in the first days after surgery, you may be concerned about:

local pain in the area of the operation;
redness of the gum tissue;
temperature rise to subfebrile levels;
slight secretion of lymph mixed with blood (ichor).

Depending on the volume of the operation, the amount of osteoplastic material introduced and implants installed, the severity of the above symptoms may vary.

The contract for treatment at our Center must indicate all acceptable postoperative conditions. Please read them carefully and the list of possible inconveniences.

When should you not worry?

Edema is not a complication if:

It gradually decreases and completely disappears after 3-7-10 days (depending on the complexity of the operation).
It is localized at the site of surgery and implantation and does not spread to healthy, nearby tissues.
It is not accompanied by severe pain and high body temperature.
It is not accompanied by bleeding or purulent discharge from the area of the postoperative wound.

In general, there is no need to worry if the swelling does not interfere with your normal lifestyle (subject to the necessary restrictions during the rehabilitation period) and gradually decreases in size. In this case, it is enough to follow the doctor’s recommendations in the postoperative period and appear in a timely manner for a scheduled examination. Usually three days for women and two days for men is enough to reduce swelling.

Usually, the attending physician knows everything in advance when planning an operation.

Feel free to ask about the number of days with noticeable post-operative swelling. Based on these calculations, we issue certificates of incapacity for work or plan operations before the weekend. Warn us about possible trips and important events; it is better to plan the operation without compromising your work and personal life. You should understand that you will have to make lifestyle changes after the procedure. Social activity after the operation should be planned to be reduced. You will not be able to be active with swelling as before the operation; it is better to sit at home for a couple of days.

Levin Dmitry Valerievich

Founder and Chief Doctor of the Center

Why we want to reduce swelling and how ice works

In addition to an aesthetic defect, large edema carries a potential risk of complications due to compression of soft tissues. The accumulation of fluid compresses small vessels, which leads to disruption of nutrition in the operation area. This is why we prescribe a drip with a decongestant component during major operations, and at home we recommend applying ice. Ice should be kept at the area of interest for 20 minutes every two hours, and so on for the first 48 hours after surgery. How it works? Cold leads to muscle spasms - that’s why we say in the cold that “the cheekbones are cramped and teeth don’t touch teeth.” Our arteries - the vessels that bring blood to the operation area - also have a muscle layer. This is part of our blood supply - organs receive oxygen and nutrients through arteries; such vessels have thick walls in order to quickly respond to changes in the body. The edema itself is formed from the liquid part of the blood - the fluid comes out (leaks) through the vascular walls as a result of the action of the inflammatory mechanism. Blood with carbon dioxide flows through the veins for a new stage of gas exchange. The muscle layer in the veins is less pronounced than in the arteries, and is often absent. It is this property that allows us to reduce swelling when applying cold - we force the arteries to contract and limit the delivery of fluid while maintaining outflow. And here it is important not to overdo it, so as not to deprive the operation area of nutrients, so you must strictly adhere to the doctor’s recommendations.

When swelling is a sign of complications

Despite the fact that the appearance of edema and other symptoms is a physiological phenomenon due to tissue damage, they should not cause unbearable discomfort to the patient. If the symptoms are pronounced and significantly worsen the quality of life in the postoperative period, you need to talk about complications and immediately consult your doctor.

Alarming signs in which you should think about the development of a complication or an abnormal reaction that requires immediate correction:

High rate of development, rapid increase in size of edema, transition of edema to the soft tissues of the face.
The swelling is dense, the consistency of an eraser.
Lack of positive dynamics - does not begin to decrease from the 3rd day after the operation.
Impaired speech and chewing function due to edema.

Associated factors also indicate the occurrence of a problem.:

An increase in body temperature above 38 degrees for longer than a day.
Severe pain at intervals of less than three hours (even when taking painkillers).
Discharge of a large amount of ichor, bleeding from the wound.
The addition of a bacterial infection, manifested in suppuration in the wound area.
Strange odors from the post-operative area.

If one or more of the above symptoms appear, you should immediately contact the dentist who performed the sinus lift or bone grafting. Find him and explain the situation, don’t delay. It is dangerous to self-medicate in such a situation , so entrust the treatment of the emerging complication to an experienced specialist.

If you are undergoing treatment at our Center, immediately contact the 24-hour support service by calling from your card.

Average cost in Moscow

Removing a tumor after implantation at home does not require large expenses. The approximate cost of the drugs is given below.

Name of service	Cost, rub.
Synthetic antiseptics
Chlorhexidine	16
Furacilin	75
Miramistin	340
Eludril	410
Herbal antiseptics
Yarrow	40
Elecampane	50
Air	55
Chamomile	60
Stomatophyte	180
Ointments and gels
Asepta	240
Kamistad	260
Holisal	315
Solcoseryl	370

Treatment of complications in dentistry

Name of service	Cost, rub.
Consultations
Dentist	600
Periodontologist	740
Implantologist	820
Healing procedures
Removing dental plaque in the area of one tooth	180
Periodontal applications in the area of one tooth	370
Application of a protective periodontal bandage	400
Laser therapy of the gum mucosa	490
Implant removal	6900
Implantation of osteoconductive material in the area of one tooth	10900
Implantation of a protective membrane	12900

Measures to prevent the consequences of sinus lifting in our Center

To avoid situations where swelling turns from a natural reaction into a problem for the patient, we have developed Uniform Quality Standards. We do not work in a rush, we provide personalized dental care, and devote the necessary time to seeing each patient. We provide a lifetime guarantee for bone grafting and implantation operations .

Preoperative preparation

If during the preparation stage obstacles to sinus lifting or bone grafting are identified, they are first eliminated, and only then the day of surgery is set.

Preoperative preparation includes:

Computer diagnostics A CT scan is performed on a high-precision GALILEOS tomograph in ENT mode to assess the condition of the bone tissue adjacent to the area of the operation of the teeth. On the day of the initial consultation, immediately after the computed tomography, the attending physician, having familiarized himself with the anatomical features, will warn you about possible individual inconveniences and the likelihood of the body’s natural reaction to the intervention.
Examination by an ENT doctor If diseases of the ENT organs are suspected based on the results of a computed tomography scan, before a sinus lift, an examination is carried out by a regular ENT doctor. If a cyst is detected in the maxillary sinus or inflammatory processes, conservative or surgical treatment is prescribed.
Sanitation of the oral cavity If any dental pathologies are detected (inflammatory gum diseases, caries, inflammatory formations on the roots of teeth), which are foci of infection, their treatment is mandatory. This reduces the risk of developing postoperative complications of infectious origin. Also, complete sanitation of the oral cavity may include professional teeth cleaning to get rid of plaque and tartar.

Experienced doctors

Bone grafting and sinus lift operations in our Center are performed only by maxillofacial surgeons . These are experienced doctors with continuous work experience of 5 years, deep knowledge of the structure of the maxillofacial system and honed manual skills.

Low-impact technologies

The use of gentle technologies without a hammer or chisel prevents injury to soft and hard tissues and, accordingly, minimizes the occurrence of complications.

Ultrasonic piezosurgery To work with hard tissues when creating access to the maxillary sinus, we use the NSK VarioSurg ultrasound device. It has a mild softening effect on the bone, without injuring it.
Using the Lift-Control instrument system A coordinated set of micro-instruments allows you to lift the thin lining of the maxillary sinus as carefully and delicately as possible without damaging it.
Biocompatible materials and growth stimulants We use only hypoallergenic drugs to increase bone volume in combination with bone morphogenetic protein (BMP). The drugs are certified in Russia and purchased from official representatives.

Maintaining sterility

Sterilization of instruments is carried out according to the AntiAIDS-AntiHepatitis program. There are 2 separate sterilization rooms, 5 sterilization autoclaving stations .
All osteoplasty and implantation procedures are performed only in sterile operating rooms. The Center has 3 operating units, which are loaded in a “checkerboard” pattern to allow for sterilization .

Branded rehabilitation

We made sure that each patient was provided with the necessary medications. You will receive a branded package with antibiotics, pain relievers, and wound care products . You won’t have to run to pharmacies after surgery. The package also contains a sheet with postoperative recommendations.

For those who want to go through the rehabilitation period faster, a set of restorative procedures :

Bioreparation Injections of biostimulants based on hyaluronic acid with amino acids, trace elements and peptides to improve the condition of the skin and reduce swelling.
PRP plasma lifting Injection of blood plasma into soft tissues to accelerate regeneration processes, improve healing, eliminate swelling and bruises.
Microcurrent therapy is a physiotherapeutic method of gently applying a weak impulse current to the skin to improve metabolism, improve lymphatic drainage, eliminate swelling, relieve spasms and pain.

24/7 patient support

The post-operative support service operates 24/7. Our specialists will monitor your well-being, remind you to take medications and follow recommendations. This is an additional level of security.

You can ask any questions to the 24-hour medical post support service by calling the numbers listed on the card in the package with medications and recommendations.

How to remove at home

The instructions for the postoperative period indicate in as much detail as possible what will help reduce the size of the swelling. Please read it carefully.

Cooling compress

The bag of post-op medications contains ice in a blue bag, freeze it in the freezer and reuse. Immediately after bone grafting, it is recommended to apply an ice pack (previously wrapped in a cloth or towel) to the cheek on the side of the operation. The duration of such a compress should not exceed 10-15 minutes, after which you need to take a half-hour break. The effect of using this simple method appears almost instantly - pain subsides, swelling stops increasing.

It should be taken into account that there are contraindications to this method of eliminating swelling, for example, trigeminal neuritis. Cold compresses are recommended for the first 24-48 hours, since it is during this time period that their effectiveness and safety are highest. If you hold the ice for longer than 15 minutes, there is a risk of hypothermia, be careful with this!

Taking medications

In addition to the local effects of low temperature, do not forget about taking medications. After osteoplasty, patients are prescribed anti-inflammatory and painkillers that help reduce or eliminate swelling and cope with other unpleasant symptoms of inflammation. In addition to anti-inflammatory drugs, multivitamins and broad-spectrum antibiotics are prescribed to prevent bacterial complications. You should take medications strictly as prescribed by your doctor or as instructed, without exceeding the permissible dose.

Diet

Also during the rehabilitation period, the prevention of edema is following a proper diet, drinking regimen, complete exclusion of chewing load on the side of the operation, regular brushing of teeth and baths with an antiseptic after each meal.

Read more about the rules of the rehabilitation period here - After a sinus lift

All these measures are aimed at relieving the symptoms of inflammation and thereby reducing swelling after sinus lifting and bone grafting. Eating spicy, too hot, hard food irritates the mucous membrane of the gums and increases swelling, and failure to maintain oral hygiene and neglect to use an antiseptic increases the risk of infectious complications.

Our doctor will inform you in detail about all the nuances of the postoperative period so that tissue restoration after surgery occurs quickly and does not cause discomfort.

What you can and cannot eat after dental implantation

On the first day of surgery, you can eat after three or four hours, when the wound has healed. Food should be liquid or pureed, at a comfortable temperature. You should not eat foods that can injure the mucous membranes. The diet must be followed for at least three weeks.

During the recovery period you need to eat:

soft or liquid food: you can puree foods with a blender, buy baby food in jars;
foods rich in calcium and vitamins;
warm food;
drink plenty of fluids.

You cannot eat seeds, nuts, sour, salty, spicy foods, sweets, alcohol, coffee, hot or cold foods. Smoking is strictly prohibited.

What pathological process can be suspected with persistent swelling?

When performing a sinus lift by an inexperienced doctor, perforation of the maxillary sinus is possible, which is accompanied by characteristic symptoms, including swelling. Consequences of this outcome of the operation:

inflammation of the maxillary sinus;
penetration of bone material into the sinus;
complicated course up to meningitis.

Since some options for bone grafting end with the implantation of an implant, there is a risk of complications associated with its rejection or the development of inflammation around it (peri-implantitis). Both of these pathological processes are associated with a violation of surgical technique and the presence of a focus of infection in the oral cavity. The problem is serious, although extremely rare.

In the case of peri-implantitis, the inflammation is localized near the dental implant and is accompanied by all the characteristic symptoms - pain, hyperemia, severe swelling.
Rejection of the implant occurs due to the influence of immune factors on it and depends on the individual characteristics of the patient’s immune system. In some cases, this process develops rapidly, while in other cases, rejection can be suspected by pronounced swelling that does not decrease with time, pain, and deterioration of the patient’s general condition.

If the swelling begins to bother you greatly and other alarming symptoms appear, you should seek qualified help from a doctor. Treatment of pathological processes must be timely and comprehensive .

Useful tips for preventing inflammation and bleeding gums

On the upper jaw, new teeth take about five to six months to take root; on the lower jaw, it takes about two to four months. The healing time of the bone and gums depends on the quality of the implant, the health of the patient and the condition of the jaw.

To ensure the process is painless and you don’t have any problems in the future, follow these recommendations:

Visit your dentist periodically (at least twice a year).
Try to quit smoking or reduce the number of cigarettes to a minimum.
Carefully care for the implant, remember that it is less strong than your natural teeth.
At the first signs of gum inflammation, consult a specialist.

Have a beautiful and healthy smile!

Ways to solve the problem

A detailed x-ray examination is carried out on a computed tomograph in macro mode, the doctor determines whether there is inflammation or whether it is just panic from noticeable swelling. After assessing the clinical situation, the doctor will prescribe treatment aimed at eliminating the cause of the swelling.

In severe cases, repeated surgical intervention may be resorted to (in case of implant rejection, purulent complications).
In cases where the swelling does not bother the patient too much and gradually decreases during the first 7-10 days, additional medical intervention is not required and this symptom will disappear on its own as the tissue heals.

Patients often come to our Center with complications after unsuccessful operations. We specialize in helping with problems related to maxillary sinus dysfunction. The specialized ENT department is equipped with the necessary equipment to eliminate sinus lift complications.

Clinical researches

Repeated clinical studies have proven the high effectiveness of Asept products. It has been clinically proven that the two-component mouth rinse ASEPTA ACTIVE more effectively combats the causes of inflammation and bleeding compared to single-component rinses - it reduces inflammation by 41% and reduces bleeding gums by 43%.

Sources:

Clinical and laboratory assessment of the influence of domestic therapeutic and prophylactic toothpaste based on plant extracts on the condition of the oral cavity in patients with simple marginal gingivitis. Doctor of Medical Sciences, Professor Elovikova T.M.1, Candidate of Chemical Sciences, Associate Professor Ermishina E.Yu. 2, Doctor of Technical Sciences Associate Professor Belokonova N.A. 2 Department of Therapeutic Dentistry USMU1, Department of General Chemistry USMU2
The effectiveness of the use of Asept “adhesive balm” and Asept “gel with propolis” in the treatment of chronic generalized periodontitis and gingivitis in the acute stage (Municipal Dental Clinic No. 4, Bryansk, Kaminskaya T. M. Head of the therapeutic department Kaminskaya Tatyana Mikhailovna MUZ City Dental Clinic No. 4, Bryansk
Study of the clinical effectiveness of treatment and prophylactic agents of the Asepta line in the treatment of inflammatory periodontal diseases (A.I. Grudyanov, I.Yu. Aleksandrovskaya, V.Yu. Korzunina) A.I. GRUDYANOV, Doctor of Medical Sciences, Prof., Head of Department I.Yu. ALEXANDROVSKAYA, Ph.D. V.Yu. KORZUNINA, asp. Department of Periodontology, Central Research Institute of Dentistry and Maxillofacial Surgery, Rosmedtekhnologii, Moscow
The role of anti-inflammatory rinse in the treatment of periodontal diseases (L.Yu. Orekhova, A.A. Leontyev, S.B. Ulitovsky) L.Yu. OREKHOVA, Doctor of Medical Sciences, Prof., Head of Department; A.A. LEONTIEV, dentist; S.B. ULITOVSKY, Doctor of Medical Sciences, Prof. Department of Therapeutic Dentistry of St. Petersburg State Medical University named after. acad. I. P. Pavlova