Post Operative Instructions For Grafting: Onlay And Sinus Lifts
Onlay grafts are grafts which are placed on the lateral aspect of the crestal bone and secured with small titanium screws. Sinus lifts are bone grafts placed in the area of your sinus and do not need screws to secure it. The instructions are the same for both.
- Swelling: the swelling will increase gradually over the next 4 days. Apply ice to the skin over the surgery sites. On for 20-30 minutes and off for 30 minutes while awake for 3 days. Afterwards apply heat pad in the same fashion for 2 days if you feel it helps resolve the pain. The swelling can be prominent in the areas of surgery and is expected.
- Bleeding: bleeding is expected in small amounts over the next 3 days. If profuse, reapply gauze pads to the surgical site, biting gently for 30 minutes and repeating if necessary. Call the office if you feel it is profuse. In cases of sinus lift grafts, you may experience bleeding through the nose. This is expected, but if profuse, call our office for further directions. Meanwhile, keep your head elevated.
- Pain: pain is expected to be experienced in a gradual fashion over the next three days after surgery. We recommend to take over the counter medication such as Ibuprofen, Motrin or Advil. No Tylenol or Aspirin products. After surgery we recommend to start with liquids such electrolyte-containing beverages, smoothies, shakes, etc. along with the over the counter medications. Ibuprofen or Motrin, 600-800 mg, three times every 8 hours for three days can be taken to keep the pain under control. Continue throughout the day and the next 3 days on a regular basis, as directed. On the second day, you could also take the prescribed narcotic medication along with the over the counter medication. The narcotic should be taken only if needed.
- Sinus precautions for sinus lifts:
- Take antibiotics until finished.
- take over the counter decongestant such as Sudafed for the next 5-10 days as instructed in your presurgical visit.
- No smoking, drinking through a straw or blowing nose for the next 4 weeks.
- If you have to sneeze, open your mouth to sneeze. If not, you will create negative pressure in your sinus, creating the possibility of bleeding and disturbing the sinus graft.
- Sutures: depending on the type of surgery, you may have restorable or non-restorable stitches. The restorable stitches may fall out over the next 2 to 10 days. The non-restorable sutures or stitches will be removed in the office after one to two weeks.
- Brushing: start brushing teeth the day after surgery inclusive of the areas of surgery. In case you use an electronic brush, it is advisable to turn it off when brushing the areas of surgery.
- Mouthwash: a non-alcoholic mouthwash or warm salt water can be used to rinse starting the day after surgery
- Diet: clear and full liquids for first 24 hours. These include electrolyte beverages, clear juices, soups, shakes, smoothies, yogurt, flan, puddings and water. After the second day, soft regular diet for 3 days: noodles, eggs, ground beef, etc. Then regular diet as tolerated.
- You may also experience areas of decreased sensation in the face. Please alert you surgeon on your first post-operative visit.
- Try to keep your head elevated 30 degrees above ground when sleeping for the first 3 days after surgery. This will help minimize swelling.
- Ambulation: although you had surgery, we would like for you to be out of bed as soon as possible after the day of surgery to prevent clots forming in the legs and traveling, causing potentially dangerous consequences. Walk around the house, sit in a chair and perform calf exercises to remain active.
- Bruising: is expected to happen in a greater or lesser degree. If upper jaw surgery, expect bruising around the cheeks and below the eye. Sometimes the eye will be swollen-shut. In the lower jaw, bruising can extend all the way down to the clavicle. This will resolve over the next two weeks.
- Head wrap: you will have a head wrap when you get home. Use it as long as possible in the next 48-72 hours following surgery. The head wrap can be removed to take showers and reapplied. Make sure the wrap is not excessively tight around your throat. There is no benefit in using it for more than 72 hours.