Sinus Lift Instruments: Sinus Elevators, Membrane Elevators and Kits

In the posterior maxilla, there is often not enough bone height for an implant after tooth loss. The maxillary sinus expands and the alveolar ridge resorbs. In sinus floor elevation, or sinus lift for short, the Schneiderian membrane is detached from the floor of the maxillary sinus and lifted, creating space underneath for bone graft material. The procedure requires delicate instruments, because the membrane is thin and tears easily. This guide gives an overview of sinus lift instruments, explains the difference between sinus elevators and membrane elevators and shows which instruments are needed for the lateral and the crestal approach.

Key points at a glance

• In the lateral sinus lift, a bone window is created in the lateral wall of the maxillary sinus. The membrane is detached through this window using sinus elevators.
• In the crestal (transalveolar) sinus lift, the sinus floor is raised via the implant bed, classically with Summers osteotomes.
• Sinus elevators (sinus curettes) have bluntly rounded working ends angled in different ways for the floor and walls of the maxillary sinus.
• Membrane elevators have a wider blade that tapers thinly and lift the membrane over a larger area.
• The most important complication is perforation of the Schneiderian membrane. Sharp edges have no place near the membrane.

Lateral or crestal?

The lateral approach (also external sinus lift or window technique) was introduced by Tatum at the end of the 1970s and published by Boyne and James in 1980. It is considered the most frequently described technique and is indicated above all when the residual bone height is low. The crestal approach with osteotomes goes back to Summers (1994). It is less invasive but requires a certain residual bone height, as the sinus floor is raised via the implant bed. How much residual bone is required for which procedure and for simultaneous implant placement is assessed differently depending on the case and the literature. The clinician decides on the basis of three-dimensional imaging.

Instruments for the lateral sinus lift

1. Incision and flap elevation

After a crestal incision, usually with a releasing incision, a mucoperiosteal flap is raised down to the bone. You need a scalpel, for example a Scalpel handle No. 3 with scale, and a periosteal elevator. The types of periosteal elevators are explained in our guide Periosteal elevators and raspatories. Retractors hold the flap back during the procedure.

2. Preparing the bone window

The window in the buccal wall of the maxillary sinus is created with a round bur, a diamond instrument or piezosurgery. The aim is to remove the bone layer by layer until the membrane shows through bluish, without injuring it. Special drills are available for this, such as the Sinus lift drill for lateral access.

3. Detaching the membrane with sinus elevators

Once the window has been created, the most delicate step begins. Using sinus elevators, the Schneiderian membrane is detached from the bone, first at the edge of the window, then at the floor and finally at the medial wall. The working ends are bluntly rounded and angled in different ways so that all areas of the maxillary sinus can be reached without piercing the membrane. The instrument always remains in contact with the bone. In our shop you will find a range of numbered sinus elevators, for example Sinus elevator 1, Sinus elevator 2 or Maxillary sinus elevator 3.

4. Lifting with membrane elevators

Membrane elevators have a wider blade that tapers thinly. They distribute the pressure over a larger area and lift the already detached membrane over its surface instead of loading it at a single point. Examples are the Membrane sinus elevator 1 and the Membrane elevator 2.

5. Augmentation and closure

Bone or bone graft material is placed into the space created and carefully compacted, for example with a Bone graft packer. The window is then usually covered with a membrane and the flap is sutured. For suturing you need a needle holder, tweezers and suture scissors.

Instruments for the crestal sinus lift

In the crestal approach, the implant bed is prepared to just below the sinus floor. The remaining bone is then gradually pushed cranially with osteotomes, lifting the membrane together with the bone. Osteotomes are cylindrical or conical pushers with graduated diameters that are tapped lightly with a mallet. Alternatively, hydraulic, balloon or piezosurgical techniques are used. Sinus elevators and membrane elevators are usually not needed in the crestal approach, or only as a supplement.

Overview: sinus lift instruments

Sets or individual instruments?

If you perform lateral sinus lifts regularly, a matched set is worthwhile. It contains instruments coordinated for the workflow and can be reprocessed in an orderly manner. In our shop you can get the Sinus lift kit for lateral access and the Lateral sinus lift kit. Individual elevators make sense to supplement an existing set or replace a worn instrument.

If the alveolar ridge is not too low but too narrow, it is often widened horizontally instead of a sinus lift (bone spreading). The Bone expander kit is suitable for this. Further sets for implantology can be found under Instrument sets.

Care and inspection

The working ends of sinus and membrane elevators must be smooth and free of burrs. After each reprocessing cycle, check under good lighting whether edges are damaged or bent. Even small burrs can injure the membrane. Cleaning, disinfection and steam sterilisation are carried out according to the manufacturer's reprocessing instructions. Tips on storage in cassettes can be found in the guide Instrument cassettes and trays.

Matching products in our shop

Scalpel handle No. 3 with scaleSinus lift drill for lateral accessSinus elevator 1Sinus elevator 2Maxillary sinus elevator 3Membrane sinus elevator 1

Matching categories

• Implantology
• Oral surgery
• Drills

Frequently asked questions

What is the difference between a sinus elevator and a membrane elevator?

The sinus elevator has a bluntly rounded, angled working end and detaches the membrane from the bone. The membrane elevator has a wider, thinly tapering blade and lifts the already detached membrane over its surface.

Which instruments are needed for a crestal sinus lift?

In addition to the implant drill set, above all osteotomes in graduated diameters and a surgical mallet. Alternatively, hydraulic or piezosurgical systems are used.

How can a membrane perforation be avoided?

Through careful window preparation, blunt and burr-free instruments and working with constant bone contact. The membrane is detached step by step starting from the edge of the window.

Are sinus lift instruments autoclavable?

Instruments made of surgical stainless steel are steam-sterilised after cleaning and disinfection. Follow the information in the reprocessing instructions.

Conclusion

A sinus lift requires only a few, but very precise instruments: a periosteal elevator for the flap, a drill or piezo for the window, sinus elevators to detach and membrane elevators to lift the Schneiderian membrane. You will find all instruments in the category Implantology, and further surgical instruments under Oral surgery.