Can a sinus lift and an implant be done in one session?
Yes. When enough bone remains under the floor of the sinus to anchor the implant firmly at placement, the sinus lift and the implant are often combined in one operation. The patient information of Cambridge University Hospitals NHS Foundation Trust distinguishes three situations:
- Little or no bone: grafting material is added through a window on the cheek side of the sinus; the implant usually follows in a second operation once the bone has healed.
- Some bone present: the material is added through the side window, and the implant can be placed in the same session.
- Some bone present, only a little height needed: the sinus floor is gently tapped upwards through the implant site and the implant is placed straight away (internal or crestal sinus lift).
What a sinus lift is, how the external and internal approaches differ and how healing goes is explained in our guide sinus lift before dental implants. This guide focuses on when both can be done at once and what that means for your trips.
What is the difference between one-stage and two-stage?
In the one-stage approach, bone material and implant go in during the same operation; in the two-stage approach, the sinus lift is done first and the implant is placed once the material has matured.
| Feature | One-stage (one session) | Two-stage |
|---|---|---|
| Number of operations | One | Two |
| When it makes sense | Enough remaining bone to hold the implant firmly | Very little bone, or no firm hold at placement |
| Waiting time before the implant | None | With the external approach, usually 4 to 9 months according to Cambridge |
| Implant healing | In parallel with the graft | Starts only after the graft has healed |
| Total duration | Shorter | Longer |
In both cases the final teeth are made only once the implant has healed. The American Academy of Periodontology (AAP) says the bone usually needs about four to 12 months to develop after a sinus lift before implants are placed, and names placement in the same procedure as an option in suitable cases. Guy’s and St Thomas’ NHS Foundation Trust gives three to six months of healing for grafts in general before implant treatment begins.
What role does the remaining bone height play?
The residual bone height is the distance between the crest of the jaw and the floor of the sinus. The lower it is, the less bone holds the implant in the first months. The research gives these reference values:
- The systematic review by D’Elia and colleagues (2019) cites about 4 to 5 millimetres as the minimum for placing an implant in the same operation as the sinus lift.
- One study it analysed (Geurs and colleagues, 2001) found significantly more implant losses at 4 millimetres or less than at 5 millimetres or more.
- Another study (Peleg and colleagues) reported survival rates of 96.4 percent at 1 to 2 millimetres and 98.9 percent at more than 5 millimetres.
- Cambridge University Hospitals reserves the internal approach for cases where some bone is already present and only a small gain in height is needed; larger gains are achieved with the external approach.
The figures vary between studies and are not the only criterion. Height and width of the remaining bone are measured on a cone-beam CT (CBCT) scan; see our guide CBCT scan before dental implants.
Why is primary stability so important?
Primary stability means the implant sits firmly in the bone at placement and does not move. It matters as much as the bone height, because the grafted material is not yet load-bearing bone at the start; in the first months the implant is held mainly by the bone that was already there.
From the studies analysed in D’Elia’s review:
- Cha and colleagues reported that tapered implants can achieve adequate primary stability even with very little remaining bone, in which case one-stage placement is possible.
- In that study, if a set resistance (15 Ncm) was not reached when the implant was inserted, the surgeons switched to a wider implant.
- Only four of the included studies reported insertion torque or the crown-to-implant ratio, so the data are limited.
Primary stability can be judged reliably only during the operation. The plan made from the CBCT scan can therefore still change on the day.
How much time does the one-stage approach save?
The one-stage approach removes the waiting time between sinus lift and implant placement and usually shortens treatment by several months. The randomised trial by Felice and colleagues (2014) shows the difference:
- One-stage group: sinus lift and implant in one operation, four months of unloaded healing, then loading with a temporary tooth.
- Two-stage group: sinus lift first, implant placement after four months, then another four months of healing.
The two-stage group was therefore loaded about four months later. Cambridge University Hospitals gives six to 12 months, sometimes longer, from the sinus lift to the final teeth. Extractions or additional grafting lengthen the process further. All the phases of implant treatment are described in our guide How long does dental implant treatment take?
What do studies show when the two approaches are compared?
In suitable patients, studies show no clear difference between one-stage and two-stage procedures; the evidence is limited, however, and caution is advised with very little bone.
- Cochrane (2014): for one-stage versus two-stage lateral sinus lift, only one trial was found, with no evidence that either approach is superior; the quality of evidence for comparisons between sinus lift techniques was rated low.
- Felice and colleagues (2014): 60 patients with 1 to 3 millimetres of remaining bone. One year after loading, three implants were lost in the one-stage group and one in the two-stage group; the difference was not statistically significant. Complications (two versus one) and bone loss at the implant were similar. The authors nevertheless consider the one-stage approach at 1 to 3 millimetres slightly riskier for implant loss.
- D’Elia and colleagues (2019): in twelve studies of one-stage placement at 5 millimetres or less, survival rates varied widely, with the lowest at 61 percent. Larger, well-designed trials are needed for very little bone.
- Tan and colleagues (2008): for the internal sinus lift with simultaneous implant placement, a three-year survival rate of 92.8 percent was calculated, with few complications.
What does this mean for your trips to Türkiye?
For international patients, the number of operations usually equals the number of stays. With the one-stage approach it generally stays at two: sinus lift and implant in the first, the teeth in the second after healing. With the two-stage approach a stay is usually added: sinus lift in the first, implant placement after several months in the second, the teeth in the third.
Also allow more time before your flight home after a sinus lift than after a simple implant placement; our sinus lift guide covers flying and aftercare. And ask before booking what happens if the operation goes differently from plan: Cambridge University Hospitals notes that the procedure may be stopped if a tear in the sinus membrane cannot be repaired and redone once the membrane has healed, and in the Felice trial some prostheses in both groups could not be fitted at the planned time. A written plan with alternatives helps you book flexible flights.
How do we plan a sinus lift and implant at Rönesans?
Whether your treatment is one-stage or two-stage is decided at our clinic in Serdivan by measuring the remaining bone under the sinus on a CBCT scan. Our dentists work out the plan together, and one dentist, whom you know from the start, accompanies your treatment.
Before treatment begins you receive a written treatment and cost plan stating, for each tooth, which procedure is planned in which order and during which stay. We carry out sinus lifts and implant placement at the clinic, under general anaesthesia if needed. During healing a temporary tooth is fitted depending on your case; the options are described in our guide temporary tooth during implant healing. After implant placement you receive an implant card, and between stays you can reach us on WhatsApp at +90 532 363 49 54 in English or German. How we organise a stay is described on our page dental treatment in Türkiye.