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Oral Surgery/Implant in #14 without sinus lift?

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QUESTION: I have been missing tooth #14 for many years (now a bridge),I want to do an implant but will need a sinus lift, x-ray showing that sinus is below where the implant will go (per my general dentist). Here's the problem:  I have chronic sinus allergies; I constantly blow my nose and sniff, I learned to live with it but I'm CONCERNED THAT AFTER THE SINUS LIFT I WON'T HEAL WELL BECAUSE of the allergies. I will have to blow my nose and sneeze, and sniff!
Is there anyway a specialist could perform an implant without sinus lift? Is it worth my time to go see a specialist? If so, what kind; oral surgeon?
I had 3 consultations with implants dentist that have told me they can do an implant/ sinus lift but did not consider my allergies.  1 dentist only told me I shouldn't do it because of my bad allergies.
I really need guidance and don't know where to start! I need to make sure of my options before just redoing the bridge.
The bridge is really old and need to be replaced asap.

Thank you for your time, I will appreciate any feedback!

ANSWER: Julie - First of all, no implant should be placed in the upper jaw bone if it sticks into the sinus.  For that reason bone grafts and sinus lift surgery is performed initially, allowed to heal and then an implant can be placed into bone throughout its length.  That is very important for stability of the implant and the ability to be functional for a long time.  

The most important issue, before any treatment is performed, sinus lift and bone graft and then implant, the sinus needs to be evaluated for infection and inflammation. So before any treatment is performed, a knowledgeable doctor would have your sinus evaluated.  My suggestion is for you to have an oral and maxillofacial surgeon evaluate your sinus and that doctor should do place the bone for a sinus lift and insert the implant.

I am a surgeon, and I am not recommending a surgeon for you as a bias, but with your sinus situation and the need for a sinus lift a specialist should perform the procedure to enhance your chance for success.

If you have additional questions, feel free to contact me again.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much Dr. for your valuable reply.
After reading this, I wonder if it's worthed to  still pursue the implant or just redo the bridge.

Thanks for your help,

Answer
Julie - Of course I can't be sure  without examining you or seeing your xrays, but if the teeth on either side of the space, where the implant would go, are very stable and aolid, then there is really no reason why a new bridge can't be made.  Dentists now recommend implants often, but a properly fabricated bridge placed on solid stable and healthy teeth is a very good replacement.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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