Bone Grafting for Implants

adequate bone for dental implants

After tooth extraction, if the walls of the socket are very thick, the sockets will usually fill in naturally with bone in two to three months. However, when the walls of the socket are very thin (such as in regions of the upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help the body fill in the empty socket with bone. This step will maintain the width and volume of bone needed for implant placement several months later.

An example of a jaw with inadequate front bone structure to support an implant
1. Inadequate Bone
A depiction of the placed bone grafting material to increase the bone structure
2. Graft Material Placed
A representation of dental implants placed after bone grafting
3. Implants Placed

There may be inadequate bone for implant placement if a tooth was removed many years ago and the remaining bony ridge is extremely thin. In such circumstances, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to the pre-existing bone, the implant can then be placed within the resulting greater volume of bone. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including using one’s own bone.

A jaw lacking enough bone in the back of the mouth for a dental implant
1. Inadequate Bone
An example of a dental implant after adding jaw structure with bone grafting
2. Graft Material and Implant Placed

Bone grafting may also be needed if the sinus cavities in the upper jaw are very large, or if they extend very low and into the tooth-bearing areas. This often occurs when teeth in the back of the upper jaw were removed many years before, leading to resorption of the remaining bone (atrophy) over a period of years, with a resulting limited amount of bone being available for implant placement. A “sinus grafting procedure” is then required. Most often, this procedure is performed in the office under local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure can often be performed at the time of implant placement.