Bone Grafting

A bone graft rebuilds jawbone that has shrunk after a tooth is lost, so an implant can be placed where the crown needs to sit. Not every implant needs one. At Pearl32 Dentistry and Wellness in Laguna Hills, the 3D cone beam scan measures your bone in millimeters, and grafting, when it is needed, is done in our own office.

The short answer

If the scan shows enough bone, the implant goes in without a graft. If there is a small shortfall, we graft at the same appointment as placement. If the shortfall is larger, or an upper back tooth sits under a low sinus, we graft first and wait three to six months, sometimes longer, before placing the implant. You see the measurements on the scan yourself.

Why bone goes missing

Bone stays because teeth load it. Once a tooth is gone the ridge shrinks, fastest in the first year, and keeps going slowly for years. Gum disease and infections around a root take bone with them. Years under a denture flatten the ridge. In the upper back jaw the sinus sits just above the roots, so even a little loss leaves too shallow a shelf for a fixture.

The four kinds of graft we do

Socket preservation graft

Done at the time a tooth is removed. The empty socket is filled with graft material and covered, so the ridge keeps its width while it heals. Placement usually follows 8 to 16 weeks later. It is the simplest way to avoid a bigger graft down the line.

Graft at implant placement

Small gaps around a fixture, or a thin spot on the outer wall, are packed with graft material during the same surgery. No extra appointment and no extra healing period.

Ridge augmentation

For a ridge that is too thin or too short to hold a fixture at all. Graft material is built onto the ridge under a membrane and left to mature for three to six months before the implant is placed.

Sinus lift

For the upper back jaw. The sinus membrane is gently raised and graft material is placed beneath it to gain height. Healing takes longer here, often six to nine months, and the sinus needs protecting for two weeks afterwards.

What the graft is made of

Most grafts use processed donor bone or a synthetic bone substitute, sometimes mixed with a small amount of your own bone taken from close by. A thin collagen membrane is laid over it to keep gum tissue out. Your body slowly replaces the graft with living bone of its own. We explain which material suits your case and why before anything is scheduled.

What it feels like

The area is numbed with local anesthetic, and sedation is available if you want it. Swelling and bruising peak at two to three days and settle over the following week. You eat soft food for a week or two and keep the site clean with a prescribed rinse. After a sinus lift you avoid blowing your nose, use a straw, or sneeze with your mouth closed for about two weeks. Smoking slows every one of these grafts and can cause them to fail, so we ask you to stop around surgery.

When a graft can be avoided

Sometimes the answer is to work around the missing bone rather than rebuild it. A shorter or narrower fixture, an implant angled into denser bone, or a full arch design with tilted rear implants can each avoid a graft. For a single tooth, a bridge needs no bone at the gap at all. The scan tells us which of these is open to you. Details are on our single implant and full arch implant pages, and the wider picture is on our implant dentistry page.

Cost

Grafting is quoted separately from the implant, because not every case needs it, and the size of the graft changes the fee. You get an itemized written estimate after the scan and before anything is booked. Third party financing is available through the plans on our financing page, and the practice is not the creditor.

Questions people ask about bone grafting

Do I need a bone graft for a dental implant?

Only if the site lacks the bone to hold a fixture in the right position, which the cone beam scan shows us. Small defects are often grafted at the same appointment as placement. Larger ones are grafted first and given three to six months to heal.

How long after a bone graft can I have the implant?

A socket graft after an extraction usually needs 8 to 16 weeks before the implant goes in. A larger ridge graft needs three to six months. A sinus lift often needs six to nine months, because that graft matures slowly. The scan confirms the bone is ready before we book placement.

Does a bone graft hurt?

The site is numbed with local anesthetic and sedation is available. Afterwards, expect soreness, swelling and some bruising that peak around day two or three and settle within a week. Over-the-counter anti-inflammatories are normally enough. It feels much like recovering from an extraction.

Where does the graft material come from?

Usually processed donor bone or a synthetic bone substitute, sometimes mixed with a little of your own bone from nearby. A thin membrane is laid over it to keep gum tissue out while it heals. Over the following months your body replaces the graft with bone of its own.

What is a sinus lift?

A sinus lift adds bone height in the upper back jaw, where the sinus sits above the roots. Once an upper molar is lost, the bone between ridge and sinus floor is sometimes too shallow for a fixture, so the membrane is raised and graft material placed beneath it. For two weeks afterwards you avoid blowing your nose and sneeze with your mouth open.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination and a 3D scan.