The dentist looked at the scan and said there was not enough bone in the upper jaw for an implant, and that a “sinus lift” would be needed before anything could start. That one sentence adds several thousand shekels to the treatment, half a year of waiting and an extra operation most people have never heard of. Here we explain what the procedure is, who really needs it, what it costs, how it can often be avoided, and what recovery looks like week by week.
A sinus lift is a small operation that raises the floor of the sinus cavity above the upper molars and fills the space with bone material, so that an implant has something to hold on to. It is needed when the remaining bone height is less than about 5 mm, usually only in the upper molar region. In Israel the price ranges from about ₪3,800 for a closed lift to about ₪15,000 for an open lift, according to the Midrag and Dapei Zahav price lists. In most cases the whole procedure can be avoided with tilted implants (All-on-4) or short implants. Initial healing takes about two weeks, and the new bone matures over 4 to 6 months before implant placement, unless the implant was placed in the same operation.
What a sinus lift is and why it is needed in the upper jaw specifically
Above the roots of the upper molars there is an air cavity, the maxillary sinus. When an upper molar is extracted, the bone beneath the sinus resorbs from below and the sinus “drops” from above, sometimes leaving only 2 to 4 mm of bone. A standard implant needs about 10 mm, so new height has to be built.
The lower jaw has no such cavity, which is why the problem is typical of the back of the upper jaw only. For the upper front teeth the solution, if needed, is a regular bone graft. The decisive scan is a CBCT (three-dimensional scan), which measures bone height in millimetres at every point. A panoramic X-ray is not enough for this decision.
Closed sinus lift versus open sinus lift
A closed lift is done through the hole drilled for the implant, raises the floor by 3 to 5 mm and suits patients with 5 mm of bone or more. An open lift is done through a “window” in the side of the jaw, adds 7 mm or more, and is meant for patients with only 1 to 5 mm left.
A 2021 review in Oral Surgery concludes that the open approach (lateral window) is intended mainly for bone heights of 1 to 5 mm, and that above 5 mm the implant can usually be placed in the same operation (Correia et al., 2021). With the closed lift there is less discomfort and the surgery is shorter. With the open lift the swelling is greater, but it is the only one that allows significant height to be built.
| Feature | Closed sinus lift | Open sinus lift |
|---|---|---|
| When | Bone height 5 mm or more, lift of 3 to 5 mm | Bone height 1 to 5 mm, lift of 7 mm or more |
| Access | Through the implant hole, no extra incision | Small window in the side bone of the jaw |
| Implant in the same operation | Usually yes | Only if about 5 mm or more remain, otherwise after 4 to 6 months |
| Initial healing | 3 to 7 days | 7 to 14 days |
| Main risk | Unseen tear in the sinus membrane | Membrane tear (about 30% of cases, usually repaired on the spot), sinusitis |
| Price in Israel (Midrag 2024) | ₪5,000 to ₪9,000 | ₪9,000 to ₪12,000 |
Who really needs a sinus lift: the scan decides, not the dentist
A sinus lift is needed when the CBCT shows less than about 5 mm of bone beneath the sinus in the area where a regular implant is planned. Patients with 5 mm or more can usually make do with a small closed lift or a short implant, and in the lower jaw the procedure is not relevant at all.
Note the word “planned”. If the implant position changes, the need for a lift sometimes disappears too. A 2014 Cochrane review examined patients with 4 to 9 mm of bone and found no clear difference in success between sinus lifts and short implants, but found more complications on the sinus-lift side (Esposito et al., Cochrane 2014). So before agreeing to surgery, it is worth asking two questions: exactly how many millimetres were measured, and which alternatives were considered.
How to avoid a sinus lift: tilted implants, All-on-4 and short implants
In most full upper-jaw restorations the sinus lift can be skipped. In the All-on-4 method the two rear implants are tilted at 30 to 45 degrees, so they bypass the sinus and anchor in the dense front bone. For a single tooth, a short implant of 6 to 8 mm sometimes saves the lift.
A systematic review of 25 studies found no difference in survival between tilted and straight implants, with cumulative survival of 94% to 98% over 6 to 11 years (Gaonkar et al., 2021). This is why, when planning full-mouth restoration in Tbilisi, the surgeon first checks whether tilting or a short implant solves the problem. There is a limit: a short implant needs 5 to 6 mm of bone, and a patient with 2 mm left under all the molars will need an open lift.
Dental bone grafting: types and materials
A sinus lift is one type of dental bone graft. The other types are socket preservation immediately after extraction, widening of a narrow ridge, and a bone block in difficult cases. The filling material is bone from the patient, bone of bovine origin or synthetic material, and usually a combination.
The patient’s own bone integrates fastest but requires a second harvesting site. Bovine bone resorbs less, which is why it is common in sinus lifts. Synthetic material suits small spaces. In all methods a membrane is placed to separate the new bone from the gum. In the Dapei Zahav price list (Israel’s Yellow Pages directory), a bone graft with membrane is priced at ₪3,240 to ₪8,100 and a local fill at ₪1,080 to ₪3,240 (Dapei Zahav, dental implant price list).
Sinus lift cost in Israel versus Tbilisi
In Israel a closed sinus lift costs about ₪3,800 to ₪9,000 and an open lift about ₪6,500 to ₪15,000, according to two public price lists, and the amount is added to the implant price. In Tbilisi the sinus lift is not included in the fixed package, but it is priced in writing from the CBCT before you book a flight.
The Israeli ranges are wide because the price lists do not define the same unit. Midrag, an Israeli consumer price-comparison site, shows ₪5,000 to ₪9,000 for a closed lift and ₪9,000 to ₪12,000 for an open one (Midrag, dental implant prices, 2024). Dapei Zahav shows ₪3,780 to ₪7,560 for a closed lift and ₪6,480 to ₪15,120 for an open one, “per half jaw” (Dapei Zahav). The guide on iDen, an Israeli dental information portal, updated in July 2025, describes the procedure and healing times but publishes no price (iDen, sinus lift).
In Tbilisi the figure is set case by case. You send a scan, the surgeon measures the bone height, and the written quote states whether a lift is needed, of which type and at what price, and it does not change after you arrive. For comparison, a Straumann® implant with crown costs ₪4,400 (£1,080) and All-on-4 for one arch ₪13,600 (£3,340), including CBCT, surgical guide and final bridge.
| Item | Israel: Midrag (2024) | Israel: Dapei Zahav | Tbilisi |
|---|---|---|---|
| Closed sinus lift | ₪5,000 to ₪9,000 | ₪3,780 to ₪7,560 per half jaw | Priced in writing before the flight |
| Open sinus lift | ₪9,000 to ₪12,000 | ₪6,480 to ₪15,120 per half jaw | Priced in writing before the flight |
| Bone graft with membrane | Not stated | ₪3,240 to ₪8,100 | Priced in writing before the flight |
| Single implant with crown | Depends on the clinic | ₪2,160 to ₪5,400 for the implant only | ₪2,200 (£540, NTA®) or ₪4,400 (£1,080, Straumann®), crown included |
| All-on-4 for one arch | Depends on the clinic | Depends on the clinic | ₪13,600 (£3,340), sinus lift usually unnecessary |
An honest calculation: for one tooth with a small closed lift the trip is usually not worth it, because flights and hotel (about ₪5,000) cost more than the difference. The saving starts at two implants or more, and especially with a full-arch restoration.
Dental implant healing time: with and without a sinus lift, and the second visit
Without a sinus lift the implant fuses with the bone within 3 to 6 months, and then the crown is fitted. With an open sinus lift in which no implant was placed, you wait 4 to 6 months for the new bone, and then another 3 to 6 months for the implant. In total 8 to 12 months.
The iDen guide gives the same numbers: two weeks for surgical healing and 4 to 6 months until the bone is ready for implants (iDen, 2025). For patients treated in Tbilisi this changes the travel plan. A closed lift with an implant in the same operation fits into a visit of about 10 days, like a regular implant. An open lift without an implant requires a short first visit for the lift, and 4 to 6 months later a second visit for placement. With All-on-4 the final bridge is fitted after the implants have fused, and your written plan states whether this happens during the stay or in an extra short visit, and what is included.
Pain after dental implants and a sinus lift: what is normal, what is not, and the nose rules
Pain after a sinus lift is similar to pain after a surgical extraction: it peaks on day two and improves clearly by day four. Cheek swelling is greater than with a regular implant and may reach the eye, and it subsides within a week. Slight bleeding from the nose in the first two days is normal.
The most important thing in the first two weeks is air pressure in the sinus. The new bone sits beneath a thin membrane, and any strong pressure can shift it or open a tear. So: do not blow your nose, sneeze with your mouth open, do not drink through a straw, do not smoke and do not dive. Clinic instructions range from one week to four weeks, and most state two weeks (3Dental, sinus lift aftercare instructions). Pain that intensifies after day four or a pus-like discharge from the nose requires contacting the dentist the same day.
Antibiotics after dental implants and a sinus lift, and painkillers
After a sinus lift most surgeons prescribe amoxicillin, sometimes with clavulanic acid, for 7 to 10 days, and the box is finished to the end even when you feel well. Patients allergic to penicillin are usually given clindamycin. For pain, ibuprofen and paracetamol alternated over the first 3 days are usually enough.
The evidence on antibiotics is less clear-cut than it seems. A 2025 umbrella review of seven systematic reviews found infection rates of 0.3% to 11.6%, and that preventive antibiotics help mainly in risk situations, such as a membrane tear or an extensive open lift, while in a simple lift without complications the benefit is unclear (BMC Oral Health, umbrella review 2025). Do not stop the tablets on your own, but you may ask the dentist to explain why and for how many days. Chlorhexidine rinses for a week are also customary, and in case of congestion a nasal spray for a few days. Anyone taking blood thinners reports this before surgery.
Exercise after dental implants, flying and returning to work
Office work can resume after 2 to 3 days, physical work after a week. Strenuous exercise, weightlifting, running and swimming are postponed for two weeks after a sinus lift, compared with about a week after a regular implant. Gentle walking is allowed from day two.
The reason is blood pressure and air pressure. Exertion raises blood pressure and can open bleeding at the lift site, and bending the head downwards increases pressure in the sinus. Flying is a separate question. Pressure changes during take-off and landing act directly on the sinus, so the accepted recommendation is to wait two weeks before flying after sinus surgery (London ENT, instructions after nasal surgery). This is why the planned stay is about 10 days for single implants and two to three weeks for a full restoration. After an open lift the coordinator books the return flight no earlier than two weeks after surgery.
Dental implant side effects and signs of failure after a sinus lift
The expected side effects are swelling, bruising of the cheek, slight nosebleed and a feeling of pressure in the sinus for a week. The less common complications are a tear in the sinus membrane, sinusitis, infection of the grafted bone and failure of the implant. Most can be treated if caught in time.
The numbers are more reassuring than they sound. A 2021 systematic review in the International Journal of Implant Dentistry found that the sinus membrane tore in 30.6% of open lifts, but after repair on the spot implant survival was 97.7%, compared with 98.9% when the membrane stayed intact, a difference that is not significant (Díaz-Olivares et al., 2021). Another review of implants that penetrated the sinus cavity without a bone graft found survival of 95.6% and complications in 14.8% of cases, mostly thickening of the sinus membrane without symptoms (Ragucci et al., 2019). Signs of failure that require an immediate check: pain that increases after a week, a taste of pus, fever above 38 degrees, a blocked nose on one side that does not improve, an implant that moves, or white granules coming out of the nose.
Aftercare instructions for dental implants and a sinus lift: a week-by-week checklist
In the first two days: ice, head raised while sleeping, soft cold food, no nose blowing and no straw. In the first week: antibiotics to the end, rinses, no smoking and no sport. In the second week: gradual return to normal food and walking. After two weeks: sport, flying and most restrictions are lifted.
| Period | Yes | No |
|---|---|---|
| Day 0 to 2 | Ice 20 minutes every hour, sleep on two pillows, soft cold food, ibuprofen and paracetamol as directed, antibiotics | Nose blowing, straw, spitting, smoking, alcohol, hot food, brushing the surgical area |
| Day 3 to 7 | Chlorhexidine rinses twice a day, gentle brushing near the stitches, walking, return to office work | Sneezing with the mouth closed, heavy bending, lifting loads, sport, smoking |
| Week 2 | Normal food on the opposite side, stitch removal (day 10 to 14), check-up with the dentist | Flying, diving, strenuous sport, playing wind instruments |
| Week 3 onwards | Sport, flying, normal food, normal brushing | Skipping the 4 to 6 month check-up before implant placement, ignoring recurring pain |
In Tbilisi the coordinator gives you this list in your language and stays available on WhatsApp after you return. The 4 to 6 month check-up can be done with your dentist at home, and the implant passport lists the grafted material and the dates.
Frequently asked questions
Does a sinus lift hurt?
Less than most people expect. The operation is done under local anaesthesia, sometimes with sedation, and there is no pain during it. Afterwards the pain is similar to a surgical extraction, peaking on day two and improving from day four. Cheek swelling is more noticeable than the pain, especially with an open lift, and subsides within a week. Ibuprofen and paracetamol are enough in most cases.
How long does it take to recover from a sinus lift?
Initial healing, meaning swelling, discomfort and return to routine, takes 3 to 7 days for a closed lift and 7 to 14 days for an open lift. Biological healing, in which the new bone matures and can hold an implant, takes 4 to 6 months. During the first two weeks the nose rules apply: no blowing, no straw, no flying.
Can the implant be placed in the same operation as the sinus lift?
Yes, if about 5 mm of bone or more remain, allowing the implant to be stabilised. In that case the lift and the implant are done together, and the only wait is 4 to 6 months for fusion, as with a regular implant. If the bone is thinner than 5 mm, most surgeons lift first, wait for the bone and only then place the implant, in two operations.
Can a sinus lift be avoided altogether?
Often. In a full-arch restoration, tilted implants in the All-on-4 method bypass the sinus and anchor in the front bone. For a single tooth, a short implant of 6 to 8 mm is suitable if 5 to 6 mm of bone remain. A bridge on adjacent teeth is a legitimate alternative for one tooth. A patient with only 2 to 3 mm left under all the molars will need a lift.
What happens if you blow your nose by mistake?
One gentle blow usually does no harm. The risk lies in strong, repeated pressure, which can shift the bone material or open a tear in the membrane. If a nosebleed, new swelling, or a feeling of air passing between mouth and nose appears after blowing, call the dentist the same day. In any case, wipe the nose gently and sneeze with the mouth open.
Is a sinus lift included in the price of dental implants in Tbilisi?
No. The fixed package includes CBCT, surgical guide, implants, surgery, crowns or bridge, transfers and a coordinator. Sinus lift, bone graft and sedation are priced separately, in writing, from the scan you send before the trip. The price in the quote does not change after you arrive, and with All-on-4 the lift is usually unnecessary.
The short version
- A sinus lift is needed only when less than about 5 mm of bone remains beneath the sinus in the upper molar region. The CBCT measures, the dentist decides, and you ask which alternatives were considered.
- In Israel the price is about ₪3,800 to ₪9,000 for a closed lift and ₪6,500 to ₪15,000 for an open one, separate from the implant. In Tbilisi the lift is priced in writing from the scan before the flight, and with All-on-4 it is usually unnecessary.
- Recovery: two weeks of nose rules (no blowing, no straw, no flying, no sport), antibiotics to the end, and 4 to 6 months until the bone is ready for an implant if it was not placed in the same operation.
Send a CBCT or panoramic scan on WhatsApp, and a surgeon in Tbilisi will return a written plan stating whether a sinus lift is needed, of which type and at what price. A coordinator replies on WhatsApp. No fee and no deposit.
