Bone Grafting
A dental bone graft rebuilds jawbone that has been lost so a dental implant has a solid foundation. Bone shrinks after a tooth is removed, and it can also be lost to gum disease, infection, or injury. The surgeon places graft material, often with a protective membrane, where bone is missing; over several months your body replaces it with new bone. Some grafts are placed at the same time as the implant; larger ones are done first.
Key takeaways
- Implants need enough bone height and width to be stable and to look natural.
- The most common grafts are socket preservation, ridge augmentation, and sinus lifts.
- Graft material may be your own bone, donor bone, animal-derived bone, or a synthetic substitute.
- Healing before implant placement is commonly several months, depending on graft size.
- 3D imaging shows exactly how much bone is available and where grafting is needed.
Why Does The Jawbone Shrink?
Tooth roots stimulate the surrounding bone every time you chew. When a tooth is lost, that stimulation stops and the bone gradually resorbs, with the fastest changes in the first months after an extraction. Other causes include:
- Periodontal (gum) disease
- Infection or cysts around a tooth
- Long-term denture wear, which puts pressure on the ridge
- Injury to the teeth or jaw
- Developmental conditions
Read more in reasons for jawbone loss and deterioration.
Common Types Of Bone Grafting Before Implants
| Procedure | When it is used | Typical timing |
|---|---|---|
| Socket preservation | At the time of extraction, to limit bone loss in the empty socket | Implant placed after healing |
| Ridge augmentation | When the jaw ridge is too thin or too short | Often before the implant; small grafts may be placed with it |
| Sinus lift | When bone under the maxillary sinus is too thin for upper back implants | Same visit or before the implant |
| Minor grafting at implant placement | Small gaps or thin bone around a new implant | Same visit |
Types Of Graft Material
| Material | Source | Notes |
|---|---|---|
| Autograft | Your own bone, often from nearby in the jaw | Contains your own living cells; requires a second site |
| Allograft | Processed human donor bone | Avoids a second site; screened and sterilized |
| Xenograft | Processed animal (usually bovine) bone mineral | Resorbs slowly, helping maintain volume |
| Alloplast | Synthetic bone substitutes | No human or animal source |
Your surgeon recommends a material based on the size and shape of the defect and your preferences. Learn more in about bone grafting.
How Long Does A Bone Graft Take To Heal?
The gum usually heals within one to two weeks. The graft takes longer to become bone that can support an implant. Small socket grafts and ridge grafts commonly heal over a few to several months; larger grafts can take longer. When grafting is done at the same time as the implant, the whole process happens during the implant's normal healing period.
Your surgeon checks healing with an examination and imaging before placing the implant.
Recovery After A Dental Bone Graft
Recovery is similar to an extraction:
- Mild to moderate swelling for a few days, peaking around day 2 to 3
- Some bruising, especially after larger grafts
- A few small graft granules may come out of the site in the first days; this is normal in small amounts
- Soft foods and chewing away from the site
- No smoking, which strongly affects graft healing
- Avoid pressing on the area with your tongue or fingers
- Follow instructions about wearing any temporary denture or flipper over the site
Call the office if you have increasing swelling after day 3, fever, persistent bleeding, or if a large amount of graft material or a membrane becomes exposed.
Who May Need A Graft?
You may need a bone graft if:
- A tooth has been missing for a long time
- A tooth was removed because of infection or a fracture
- You have had gum disease
- You have worn a denture for many years
- You want implants in the upper back jaw below the sinus
3D cone beam CT imaging measures bone precisely so the surgeon can tell you whether grafting is needed before any surgery is booked.
Bone Grafting At Our Waterloo Office
Our oral surgery office at 96 Union Street East in Waterloo provides socket preservation, ridge augmentation, sinus lifts, and implant surgery for patients from Waterloo, Kitchener, Cambridge, Guelph, and Stratford, in partnership with each patient's own dentist. See our bone grafting and dental implants pages, or read dental implant cost in Ontario for how grafting affects fees. Call +1 (519)-743-7811 to book a consultation.
Sources
- Bone grafting, socket preservation, and ridge augmentation, Dr. Kevin J. McCann Oral & Maxillofacial Surgery.
- Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Journal of Clinical Periodontology, 2008.
FAQ
Is A Bone Graft Always Needed For A Dental Implant?
No. Many patients have enough bone for an implant without grafting. Grafting is more likely when a tooth has been missing for a long time, after infection, or in the upper back jaw.
Does A Dental Bone Graft Hurt?
It is done with local anesthetic, and IV sedation is available. Afterward, most patients have soreness similar to an extraction, managed with medication for a few days.
How Long After A Bone Graft Can I Get An Implant?
It depends on the graft. Small grafts may allow implant placement at the same visit or after a few months; larger grafts often need several months of healing before the implant.
What Are Bone Graft Granules In My Mouth?
After a graft, a few small, sand-like granules may come out of the site in the first days. A small amount is normal. Call the office if a lot of material comes out or the site opens.
Is Donor Or Animal Bone Safe?
Graft materials used in dentistry are processed, screened, and sterilized. Your surgeon will explain the options and you can choose a material you are comfortable with.
This article is general patient education and does not replace an examination, diagnosis, or the written instructions from your own surgeon or dentist. If you have heavy bleeding, trouble breathing or swallowing, or rapidly spreading swelling, call the office or go to the nearest emergency department.