Bone Grafting for Dental Implants
An implant needs bone around it the way a post needs ground. When a tooth has been missing for a while, or the socket is damaged, a bone graft rebuilds what's needed. Most grafts heal in three to six months and use donor bone or your own, often with PRF from your blood.
“Several doctors told me a new implant was out of the question because the bone loss was too severe to be grafted. … He performed masterful bone/tissue graft and now my new implant is firmed anchored. Dr Verrett is awesome! I highly recommend him!!”
“Dr Verrett was confident, experienced, knowledgeable, and very personable. I had been uncertain about where to go for care and receiving conflicting information about the best course of action … I soon trusted that I was in good hands and now feel very hopeful for a good outcome with bone graft and future implant.”
When Grafting Is Needed
- Socket preservation. When a tooth is removed, the socket is filled with graft material so the bone keeps its shape while it heals. This is the most common graft and the simplest, and it makes the later implant more predictable. A systematic review by Tan and colleagues found that a socket left alone loses roughly 29 to 63 percent of ridge width and 11 to 22 percent of ridge height in the first six months, and a meta-analysis by Avila-Ortiz and colleagues found that ridge preservation limits that loss, by about 1.9 millimeters of width and 2.1 millimeters of height at the middle of the cheek side, compared with extraction alone.
- Ridge augmentation. When bone has already shrunk, in height or width, it is rebuilt with graft material held in place by a membrane and, in larger cases, small fixation pins. Healing takes four to six months.
- Sinus lift. In the upper back jaw, the sinus often sits where implant bone is needed. A sinus lift adds bone beneath it. Sinus lift.
- Grafting at the time of implant placement. Thin spots around a new implant are grafted at the same visit.
What Happens
Local anesthetic, with sedation if you prefer. The gum is opened, the site is prepared, graft material is placed and covered, and the gum is closed with sutures. Thirty minutes to an hour and a half depending on size. Sutures come out or dissolve in one to two weeks.
Materials
We use graft materials with long track records: processed human donor bone (allograft), bovine-derived bone mineral (xenograft), synthetic mineral, and your own bone when it’s the right choice. Tell us if you have a religious or personal objection to human or animal-derived materials; alternatives exist. Platelet-rich fibrin, made from a small blood draw at the start of the procedure, is used in most grafts to support healing. How PRF works.
Recovery
Two to three days of swelling, a week of soft food, and no pressure on the site. Do not lift your lip to look at it and do not brush the area until we say so. An anti-inflammatory is usually prescribed, and antibiotics when the case calls for them. Smoking must stop for the healing period. It is among the largest modifiable risks in implant surgery: Chrcanovic and colleagues, pooling 107 studies, found that implants placed in smokers failed at 6.35 percent against 3.18 percent in non-smokers, with significantly more postoperative infection and marginal bone loss.
Cost and Insurance
Grafting is estimated separately from the implant on your written plan, so you can see each part. Dental insurance sometimes covers a portion of grafting. Cost and insurance.
Frequently Asked Questions
Where does the graft material come from?
Most grafts use processed human donor bone (allograft), bovine-derived bone mineral (xenograft), or a synthetic mineral, all used for decades with predictable results. Tell us if you have a religious or personal objection to human or animal-derived materials; alternatives exist. In some cases a small amount of your own bone is used. A resorbable membrane usually covers the graft, and platelet-rich fibrin from your own blood is often added to support healing. Dr. Verrett will tell you exactly what is planned for your case.
Does every implant need a graft?
No. Many implants go into healthy bone with no graft at all. A graft is needed when a tooth has been missing long enough for the ridge to shrink, when the socket walls were lost to infection or extraction, or when the bone is too thin for an implant of the right size.
Can the graft and the implant be done at the same time?
Sometimes. A small graft to thicken the bone can be placed with the implant. A larger rebuild is done first and left to heal for three to six months before the implant is placed.
How long does a graft take to heal?
Socket preservation after an extraction heals in about three months. Larger ridge augmentation takes four to six months. A follow-up scan is taken before the implant when the planning needs it.
What does recovery feel like?
Like a moderate tooth extraction: swelling for two to three days, soreness managed with ibuprofen and acetaminophen, and a soft diet for a week. You must not disturb the site; the written instructions explain what that means.