Gaining a Few Extra Millimeters of Bone — Without the Window
The crestal sinus lift — also called an internal sinus lift, transcrestal sinus elevation, or osteotome sinus lift — approaches the sinus from below, through the implant osteotomy site. Instead of creating a lateral window in the maxillary wall, the surgeon uses osteotomes or specialized hydraulic instruments to gently fracture the thin bone of the sinus floor and improve the Schneiderian membrane from the underside. Bone graft material is pushed up through the osteotomy into the created space beneath the membrane, and the implant is placed in the same session.
This technique is appropriate when the residual bone height below the sinus floor is 5-7mm and you need to gain an additional 3-5mm. It is a shorter, less invasive procedure than the lateral approach — no lateral flap, no bony window, less post-operative swelling, and faster recovery. At Aloha Dental Specialty Center, Dr. Walied Eldomiaty uses CBCT to measure the exact residual bone height and sinus membrane thickness to determine candidacy. The crestal approach works best when the membrane is of normal thickness, the sinus floor is flat (no septa), and the bone is dense enough to provide initial implant stability.
The procedure adds approximately 15-20 minutes to the implant placement. The osteotomy is prepared to within 1mm of the sinus floor. A sinus lift osteotome or hydraulic instrument gently pushes the floor upward, tenting the membrane. Bone graft material mixed with PRF is introduced through the osteotomy, pushing the membrane further up. The implant is then placed through the same osteotomy, gaining support from the native bone while the graft integrates above. The implant and graft heal simultaneously over 4-6 months before the implant is loaded with a crown.
Serving Beaverton, Aloha, Hillsboro & Washington County
Aloha Dental Specialty Center is located at 18455 SW Alexander St, Suite B, in Beaverton, Or Oregon. We serve patients from across the Tualatin Valley and greater Portland metro, including Aloha, Hillsboro, Tigard, Lake Oswego, and Tualatin. Our Beaverton office is a 5-minute drive from Aloha, 10 minutes from Hillsboro, and 15 minutes from Tigard via SW 185th Avenue.
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Intel Campuses (Ronler Acres & Jones Farm)
10 to 15 minutes via NW 185th Ave. We accommodate the schedules of tech professionals who need efficient, high-quality specialty care.
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Nike World Headquarters
About 8 minutes via SW Baseline Rd. We frequently see patients from the Nike campus for surgical and implant procedures with sedation options.
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Streets of Tanasbourne & Orenco Station
Easily accessible via US-26 and NW 185th. Local general dentists in these communities regularly refer patients to us for specialty procedures.
Why Local Dentists Refer to Us
We work as a trusted partner to general dentists throughout the Tualatin Valley. When cases require CBCT-guided planning, IV sedation, bone grafting, or other advanced procedures, local providers refer to Dr. Ostovar for his experience with implant procedures and predictable results.
We handle the procedures within our scope and coordinate closely with your general dentist for smooth continuity of care from start to finish.
Office hours: Mon–Fri 8 AM–5 PM (Thu & Fri until 6 PM), Sat 8 AM–2 PM
Understanding Your Investment
At Aloha Dental Specialty Center, we provide transparent pricing before any treatment begins. The cost of your procedure depends on clinical complexity, materials used, and sedation requirements. We walk you through every line item during your consultation so there are no surprises.
What Affects Cost:
- Clinical Complexity: Bone loss, sinus proximity, nerve involvement, or the need for grafting affects treatment planning and surgical time.
- Materials: We use research-backed implant systems, purified bone graft matrices, and high-strength ceramics from established manufacturers.
- Sedation: Options range from local anesthesia to IV sedation, each with different associated costs. We discuss the best option for your comfort and procedure.
Insurance & Financing
We accept most major dental insurance plans and file claims on your behalf. Our team verifies your benefits before treatment and submits pre-treatment estimates with clinical documentation to maximize coverage.
For out-of-pocket costs, we partner with CareCredit and Cherry for flexible payment plans. We also offer our ADSC Dental Savings Plan for patients without insurance.
Recovery & Healing Timeline
Understanding the healing process helps you plan ahead and follow post-operative instructions for the best possible outcome.
First 48 Hours
Mild swelling and tenderness are normal. Apply ice packs in 20-minute intervals and take prescribed or over-the-counter anti-inflammatory medication. Eat soft foods and avoid the surgical site when chewing.
Days 3 to 7
Swelling peaks around day three and then improves. The tissue begins closing over the surgical site. Continue with soft foods and use any prescribed antimicrobial rinse. Most patients return to normal activities during this phase.
Long-Term Healing
Surface tissue heals within two to three weeks. Bone integration and deep healing continue for three to six months. Avoid smoking, follow up as scheduled, and maintain good oral hygiene throughout recovery.
Questions during recovery? Call us at (503) 822-0096. We are available for post-operative concerns.
Hydraulic Sinus Elevation: A Membrane-Friendly Technique
Traditional crestal sinus lifts use osteotomes — hand instruments that are tapped with a mallet to fracture the sinus floor and tent the membrane upward. This technique, while effective, relies on controlled percussion that can be uncomfortable and anxiety-producing even under local anesthesia. Hydraulic sinus elevation is an advancement that uses fluid pressure (typically saline or PRF liquid) injected through the osteotomy to improve the membrane. The fluid distributes pressure evenly across the membrane surface, reducing the risk of point perforation. The membrane balloons upward smoothly, creating space for graft material without the impact forces of osteotome tapping. This approach is gentler on both the membrane and the patient.
Why Choose ADSC?
The crestal sinus lift is inherently a "blind" procedure — the surgeon cannot directly see the membrane. The integrity of the membrane is assessed indirectly: by the resistance felt during osteotome advancement, by the Valsalva maneuver (asking the patient to blow gently while the surgeon watches for air bubbles in the osteotomy), or by the behavior of the hydraulic fluid. A surgeon experienced with the crestal technique develops the tactile sensitivity to feel when the sinus floor fractures and the membrane begins to tent — and knows when to stop pushing. This tactile judgment prevents over-elevation and perforation in a space that cannot be directly visualized.
Your Sinus Lift Crestal Approach Treatment Steps
- Consultation & Exam: Comprehensive sinus lift crestal approach evaluation with CBCT 3D imaging at our Beaverton office.
- Treatment Plan: Our experienced dental team discusses your sinus lift crestal approach options, timeline, and costs. We use advanced 3D imaging and evidence-based protocols across general dentistry, endodontics, and pediatric care.
- Treatment: Procedure performed with comfort options including sedation if needed.
- Follow-Up: Post-treatment monitoring and care coordination for best healing.
Schedule Your Appointment Today
Book a consultation with our team at Aloha Dental Specialty Center in Beaverton, OR. Call (503) 822-0096 Office hours: Monday through Friday 8 AM to 5 PM (until 6 PM Thursday and Friday), Saturday 8 AM to 2 PM. or request an appointment online.
Related Services at Aloha Dental Specialty Center:
Dental Implants · Oral Surgery · Root Canal · Invisalign · Periodontics · Pediatric · TMJ Treatment · Sedation · Cosmetic · Emergency · Sleep Apnea
A Note from Your Dental Team
In my experience, the patients who get the best results from sinus lift crestal approach are those who come in with realistic expectations and follow their post-treatment instructions carefully. I’d rather spend extra time explaining what to expect than have a patient be surprised later.
“Every patient I see has a different story, a different set of concerns, and a different definition of what ‘success’ looks like. That’s why I don’t believe in one-size-fits-all treatment plans. When you come in for a consultation, I’ll listen first, examine second, and recommend third.
I also won’t recommend a procedure you don’t need. If your tooth can be saved with a filling instead of a crown, I’ll tell you that. If watchful waiting is appropriate, I’ll explain why. My job isn’t to sell treatment — it’s to give you my honest clinical judgment so you can make an informed decision.
If you have questions about whether this treatment is right for you, or if you’ve been told you need this procedure by another dentist and want a second opinion, call us at (503) 822-0096. We’re happy to take the time to explain everything — no rush, no pressure.”
— Aloha Dental Specialty Center, Beaverton, OR
I know many patients feel anxious about dental procedures — you’re not alone in that. What I hear most often after treatment is: “That was so much easier than I expected.” We’re here to make this as comfortable as possible for you.
Typical Healing Timeline:
Days 1-3: Initial healing, mild swelling managed with ice and medication. Days 4-7: Swelling subsides, gradual return to normal diet. Weeks 2-4: Soft tissue heals completely. Months 2-6: Bone remodeling and full integration (for surgical procedures). Individual recovery varies — we provide detailed post-op instructions specific to your procedure.
For additional clinical information, visit the American Dental Association (ADA).
Reviewed by Dr. Walied Eldomiaty, DDS, Periodontist — March 2026. Clinical information on this page reflects current evidence-based dental practices.
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Frequently Asked Questions
A crestal sinus lift is a minimally invasive procedure that improves the sinus membrane from below, through the implant drilling site. It allows simultaneous sinus augmentation and implant placement in a single procedure, gaining 3-5mm of additional bone height.
The crestal approach works from below through the implant site — no lateral window, no separate flap. It is less invasive, has a shorter procedure time, and involves less post-operative swelling. However, it is limited to gaining 3-5mm of height and requires at least 5-6mm of existing bone. The lateral approach can gain 10-12mm or more.
Yes — simultaneous implant placement is the standard protocol for crestal sinus lifts. The implant is placed through the same osteotomy used for the sinus elevation, gaining stability from the native bone while the graft matures above. This is one of the primary advantages of the crestal approach.
Dr. Walied Eldomiaty recommends crestal (osteotome) approach when existing bone height is 5mm or more — this is less invasive with faster recovery and the implant is typically placed simultaneously. The lateral window approach is used when bone height is less than 4-5mm, requiring more extensive augmentation (8-12mm). Your CBCT scan measurements determine which technique provides the safest and most predictable result for your specific anatomy.
A crestal sinus lift typically adds 2-4mm of bone height. This is sufficient when you have at least 5-6mm of natural bone below the sinus. For patients with less than 4-5mm of bone, the lateral window approach provides more bone augmentation (8-12mm) but requires longer healing time.
Candidacy is determined by CBCT measurements. You need at least 5-6mm of residual bone below the sinus floor. The sinus membrane should be of normal thickness (not significantly thickened from chronic sinusitis). The sinus floor should be relatively flat (no significant septa in the area). These factors are evaluated during your consultation.
If you have less than 5mm of residual bone, a lateral window sinus lift is recommended instead. The lateral approach provides direct visualization and access for larger augmentations. Dr. Walied Eldomiaty will recommend the appropriate technique based on your CBCT measurements.
Because the crestal approach is performed without direct visualization, a membrane perforation may not be immediately detected. If suspected, the procedure may continue with additional precautions, or it may be converted to a lateral approach where the membrane can be directly visualized and repaired. Small perforations during crestal elevation often heal without complications.
The implant and graft heal simultaneously over 4-6 months. Soft tissue heals within 1-2 weeks. Post-operative restrictions (no nose blowing, no flying) apply for 2 weeks. The implant is loaded with a crown after CBCT confirms adequate bone integration.
Osteotomes are hand instruments with concave tips used to compress and shape bone. In crestal sinus lifts, they are used to gently fracture the sinus floor and push it upward, tenting the membrane. They are tapped with a small mallet — the controlled impact fractures the thin sinus floor without damaging the membrane above.
Hydraulic sinus elevation uses fluid pressure (saline or PRF) injected through the osteotomy to improve the sinus membrane. The fluid distributes pressure evenly, reducing the risk of membrane perforation compared to osteotome tapping. It is a gentler alternative that produces similar results.
Crestal sinus lift recovery is minimal — most patients return to normal activities within 1-2 days with mild pressure sensation in the cheek area. Because the implant is typically placed at the same time, the total healing period is 4-6 months for osseointegration. Avoid nose blowing, sneezing with mouth closed, and straw use for two weeks.
The same sinus precautions apply: no forceful nose blowing for 2 weeks, sneeze with mouth open, no flying for 1-2 weeks, no straw use, and no smoking. These restrictions protect the improved membrane during early healing. Other than these, activity restrictions are minimal.
Crestal sinus lifts have a success rate above 95% at ADSC. The technique is predictable when patient selection criteria are met — primarily adequate initial bone height (5mm+) for simultaneous implant placement. We verify sinus anatomy and bone dimensions with CBCT 3D imaging before recommending this approach.
Yes. If implants are being placed on both sides of the upper jaw and both sides need crestal sinus elevation, both can be performed in a single visit. Since the crestal approach is minimally invasive, bilateral procedures are well-tolerated.