Bone loss in the jaws and around the teeth can be the result of missing teeth, periodontal disease, or trauma. This bone loss is more than a detriment to oral health and function; it can also alter facial appearance as the support for the natural contours of the face is diminished.
When a tooth is extracted, the natural stimulation to the underlying bone that is generated by the forces of biting or chewing is lost. In fact, bone width can be reduced by as much as 25% in the first year following tooth loss.
With grafting procedures, the dental bone can be restored to its original dimensions to maintain facial esthetics, repair the damage caused by periodontal disease as well as facilitate the success of procedures such as the placement of dental implants. A bone graft provides a platform or “scaffolding” for new bone growth and the material for a bone graft can be derived from the patient, other donor sources or be comprised of synthetic, bone-like materials.
There are several types of grafting procedures that can be performed with the particular approach depending upon the needs of the case.
A bone graft can be placed immediately upon the extraction of a tooth or some time after tooth loss. Placing a bone graft at the time of tooth removal reduces the amount of bone loss in the area to maintain the hard tissue support that is required for the future placement of a dental implant. When a bone graft is placed a while after tooth loss, a separate surgical procedure is required to reflect the soft tissue, expose the underlying bone, place a graft and then suture the soft tissue back into place.
For patients lacking a sufficient amount of bone for a dental implant to replace a maxillary back tooth (upper back tooth), a procedure known as a “sinus lift” may be performed. During this surgical procedure, the sinus membrane is lifted and bone graft material is added between the jaw and the floor of the sinus to provide the needed bone height to successfully support a dental implant.
In addition to bone grafting for purposes of ridge preservation or augmentation to allow for dental implants, an aesthetic ridge augmentation procedure to restore the natural contours of the bone is sometimes performed in preparation for fixed bridgework to achieve a more cosmetically pleasing result.
To guide tissue regeneration as well as protect the graft and promote healing, special membranes and biologically active materials may be placed over the grafting material.
A bone graft is a surgical procedure that places material into areas of bone loss to encourage new bone growth and restore structural support. The graft acts as a scaffold that allows the body's own bone cells to migrate in and gradually replace the graft material with living bone. Over time a successful graft restores contour, volume, and strength to the jawbone.
In dentistry, bone grafts are commonly used to preserve the jaw after tooth loss, rebuild bone damaged by periodontal disease or trauma, and create a stable foundation for dental implants or other restorative work. Restored bone volume also helps maintain facial contours and support surrounding soft tissues. The specific technique and timing are selected based on the clinical goals and the patient’s overall oral health.
Jawbone loss can result from missing teeth, chronic periodontal (gum) disease, infection, or facial trauma. When a tooth is removed, the normal stimulation the bone receives from biting and chewing disappears, which can lead to resorption of the underlying bone. Over time this process can reduce bone height and width and compromise the function of adjacent teeth and restorations.
Bony deficiency also affects facial esthetics by diminishing the natural contours that support lips and cheeks, which may change the appearance of the lower face. Significant bone loss can make it difficult or impossible to place dental implants without prior grafting. Early evaluation and intervention help preserve both function and appearance.
Several graft materials are commonly used, each with advantages based on the clinical situation. An autograft uses the patient’s own bone and is valued for its biologic compatibility and healing potential, while an allograft uses processed human donor bone that provides a safe scaffold without the need for a second surgical site. Both options are well established in oral surgery.
Other choices include xenografts derived from animal sources and alloplasts, which are synthetic bone-like materials that can support bone formation. The surgeon may also use specialized membranes and biologically active materials to guide tissue regeneration and protect the graft during healing. Your clinician will recommend the material best suited to your needs based on the size and location of the defect and overall treatment plan.
A bone graft can be placed immediately at the time of tooth extraction or at a later date, depending on clinical circumstances. Immediate grafting, often called socket preservation, reduces the amount of bone lost after extraction and helps maintain the ridge dimensions needed for future implant placement. This approach can simplify later restorative procedures by preserving the hard tissue architecture.
If a graft is delayed, a separate surgical procedure is required to expose the site, place the graft material, and secure the soft tissue for healing. The choice between immediate and delayed grafting depends on factors such as infection, the condition of surrounding tissues, and the long-term restorative plan. Your surgeon will evaluate the extraction site and discuss the timing that offers the best prognosis.
A sinus lift is a specialized grafting procedure performed in the upper posterior jaw when the sinus floor is too close to the alveolar ridge to allow stable implant placement. By gently elevating the sinus membrane and placing graft material between the sinus floor and the jaw, the procedure increases vertical bone height in the posterior maxilla. It is commonly recommended when prior tooth loss or anatomic factors have reduced available bone.
After a sinus lift, the grafted area requires time to integrate and form new bone before an implant can be placed, although in some cases simultaneous implant placement is possible. Careful imaging and planning are used to determine the amount of augmentation needed and the optimal timing for implant placement. The procedure is a predictable way to create the bone volume needed for long-term implant success in the upper back jaw.
Ridge preservation and augmentation maintain or restore the shape and volume of the alveolar ridge so that implants can be placed with proper alignment, stability, and esthetics. Preserving the ridge immediately after extraction minimizes the need for extensive grafting later and helps ensure there is enough bone to fully support an implant long term. Augmentation procedures can rebuild deficient areas to recreate natural contours for both function and appearance.
When adequate bone volume and contour are achieved, implants can be positioned in an optimal prosthetic location, which enhances loading distribution and esthetic outcomes. Surgeons often combine grafting with guided tissue regeneration techniques, including membranes and biologic adjuncts, to protect the graft and direct predictable healing. Proper ridge management is a critical step in comprehensive implant planning.
After a bone graft, patients commonly experience mild to moderate swelling, bruising, and some discomfort that is typically controlled with prescribed or recommended medications. Initial healing usually takes one to two weeks for soft tissues, while the underlying graft may require several months to integrate fully and form mature bone. Your clinician will provide specific post-operative instructions to manage symptoms and protect the graft site.
Maintaining good oral hygiene, following dietary recommendations such as a soft-food diet for a short period, and avoiding behaviors that disrupt healing such as smoking are important for a successful outcome. Routine follow-up appointments allow the surgical team to monitor healing and determine the appropriate time for any subsequent procedures, such as implant placement. Adhering to the care plan improves predictability and reduces the risk of complications.
As with any surgical procedure, bone grafting carries potential risks including infection, graft rejection or failure, bleeding, and delayed healing. Specific areas such as the posterior upper jaw also carry a small risk of sinus-related complications when a sinus lift is performed. Most complications are uncommon and can be minimized with careful surgical technique and appropriate patient selection.
Your surgeon will review your medical and dental history, discuss potential risks in your case, and outline steps taken to reduce those risks, such as sterile technique, antibiotics when indicated, and protective membrane placement. Promptly reporting any unusual symptoms, such as increasing pain, persistent swelling, or fever, helps the team identify and manage problems early. A thorough consultation and adherence to post-operative instructions are key to a safe recovery.
Determining the need for a bone graft begins with a comprehensive clinical exam and imaging studies such as cone beam computed tomography (CBCT) or panoramic radiographs to evaluate bone quantity and quality. The treatment team assesses the height, width, and density of the jawbone relative to the planned implant position and prosthetic goals. This diagnostic information allows the clinician to recommend whether grafting is required and which technique will yield the best long-term result.
At Stahl Dental Studio in Fair Lawn the team combines clinical examination with advanced imaging and treatment planning to create a personalized plan for each patient. The plan addresses whether ridge preservation, augmentation, or a sinus lift is needed and outlines the anticipated sequence of procedures. Patients receive a clear explanation of the clinical rationale so they can make informed decisions about their care.
Preparation for a bone graft typically includes a medical history review, any necessary preoperative imaging, and instructions about medicines and smoking cessation to optimize healing. Your clinician may ask you to avoid certain medications that increase bleeding risk and will provide guidance about fasting if sedation or general anesthesia is planned. It is important to arrange transportation if you will receive sedation.
After the procedure, follow-up care focuses on controlling swelling and discomfort, maintaining infection-free healing with gentle oral hygiene measures, and attending scheduled visits so the surgical site can be monitored. You will be advised on activity restrictions, dietary guidelines, and signs to watch for that warrant prompt contact with the office. Adhering to the aftercare plan helps ensure a predictable recovery and the best possible outcome for your graft and any subsequent restorative treatment.
