Is Bone Grafting Necessary Before a Dental Implant?

A bone graft is needed when a person’s jaw lacks sufficient healthy bone to support the implant. This bone loss could be from missing teeth, gum disease, trauma, or aging. 

At The Practice, we believe that educating you about every step will ease anxiety and empower you to make the best decision.

What is a Bone Graft?

A bone graft is a way to reinforce areas of missing or weak bone by placing some material where the jawbone needs extra support. This material can come from a different part of your jaw, from a donor, or it might be a synthetic material designed to encourage new bone growth. Whatever the graft, your natural bone grows and fuses with the grafted material, giving your jaw the strength to support your new implant. 

Without enough bone, the implant will not integrate, resulting in instability. Rebuilding the bone before the implant gives the best chance for the natural bone to bond and last for years.

Why Bone Grafting May Be Needed

Once a tooth is lost or removed, the jawbone in that area no longer receives the stimulation it needs, thus the bone will shrink. Gum disease can also cause the bone to deteriorate. 

Bone density plays a crucial role in implant success. Dental implants are anchored into the bone, like the roots of your natural teeth. If the bone isn’t dense enough, the implant cannot integrate. This will lead to the implant moving, causing it to fail. A healthy jawbone gives an implant the best possible foundation.

We offer an evaluation to decide if a graft will be suitable, but the following indications are an indicator that you will need a graft:

• A tooth has been missing for several months

• A history  of gum disease or bone infections

• A sunken appearance around the mouth

How Dentists Determine If You Need a Bone Graft

At The Practice, we use a holistic system to determine if you need a bone graft:

• Detailed imaging using CBCT scans

• Precise measurement of bone volume and thickness

• Assessment of Dental History

3D Imaging

The most effective tools for determining the need for grafts are detailed imaging technology, digital X-rays, and cone-beam CT (CBCT) scans. These are easy and painless ways to get a complete view of your entire oral structure and jawbone. These tools can also identify obscure bone loss.

In-Office Evaluations and Bone Measurements

Once we have the images, it is time for the in-person exam. Our team assesses the gum and jaw, reviews the results of the images, and discusses your dental history. We look for a soft spot, a history of infection, or anything else that will determine how we proceed.

When a Sinus Lift Might Be Recommended

If you need an implant in your molars and premolars, we may need to consider a sinus lift. This bone graft is performed on the upper jaw, where the bone is thinner and sits near the sinus cavity.

To perform a sinus lift, the sinus membrane is lifted and bone material is placed underneath, on top of the jawbone. This creates enough space to secure the implant. A sinus lift is a common, effective way to secure implants. 

At The Practice, our team is here to walk you through the process, so you know why we recommend what we advise for your case. 

Does Everyone Need a Bone Graft?

Many clients can get a dental implant without additional structural support. If the jawbone is healthy and thick enough where the implant is being placed, we can proceed. We don’t want our clients to undergo more procedures than necessary to achieve their dream smile!

When Bone Grafts Are Not Required

If the jawbone is strong and healthy, then a graft will not be needed. As long as the implant can anchor securely and fuse with the bone, everything is fine. We can determine if you need a graft during your tailored assessment. At The Practice, we always aim to preserve as much of your natural bone as possible.

Patients With Sufficient Bone Mass

Many patients will have enough bone mass to go ahead with the dental implant. The key indicators of sufficient bone mass in the jaw are:

• The loss or extraction of the tooth occurred recently.
  
  

• There has been no gum disease or infection.
  
  

• Your jawbone is dense and healthy in scans and assessments.
  
  

Implants Placed After Extraction

Immediate implant placement preserves bone structure. We extract the tooth and then place the implant right after. With careful planning and our expert team, this means there is no need for a bone graft.
This procedure is not the solution for every case. If there is already an infection or the surrounding bone is unstable, a graft will be unavoidable. At The Practice, we want to create a plan that fits your needs and delivers the results you are hoping for.

The Bone Grafting Procedure 

It’s natural to be nervous when you learn you need a bone graft. We will walk you through the process so you feel informed, not intimidated. Before the procedure, we will review your medical history, discuss your sedation options, and address all questions you may have. We don’t believe in rushed appointments or unpredictable results.

After you are comfortable and we are set up, we will apply a local anesthesia. Then we make a small incision in the gum, place the graft material, secure it, and cover it again. The whole process is quick and straightforward. Sedation is not often needed, but we will discuss all options that make you feel comfortable and supported.

Mild swelling, tenderness, and discomfort are expected over the next few days. The recovery is easy to manage with soft foods and over-the-counter pain relief. On our end, we will follow the healing process at follow-up appointments to ensure the implant and bone graft are bonding as expected.

Types of Bone Graft Materials

There are three primary materials used in bone grafts. All have strengths and weaknesses, so choosing one comes down to your preference and what is available.

• Autograft: Bone taken from another area of your body (such as the jaw or hip).
• Allograft: Bone from a donor that has been processed to be compatible and safe. The primary benefit of this one is that no secondary surgery is required.
  
  
• Synthetic Grafts:  Synthetic material engineered to stimulate natural bone growth. 

We would be delighted to discuss what material will best balance personal comfort and long-term success.

Risks and Complications of Bone Grafting

Most individuals experience mild and short-term side effects after a bone graft. These may include:

• Swelling or tenderness near the graft site
  
  
• Minor bleeding in the first 24 hours
  
  
• Bruising along the gum or cheek area
  
  
• Temporary discomfort, especially when chewing or brushing near the area
  
  

Rare Complications

There are a few complications that can transpire outside these side effects, including:

• Infection
• Graft failure
• Sinus complications 
• Nerve sensitivity

Our team will minimize these possibilities using expertise and cutting-edge technology. If any of these complications do occur, we will resolve the issue as fast as possible. 

Alternatives to Bone Grafting

If your jawbone lacks the mass required for an implant, but you are concerned about grafting, there may be other options. Short and Zygomatic implants are specialized implant procedures for cases where a graft is not possible or unwanted.

Short Implants

These implants are smaller in length, but can still provide stability in the lower jaw. They are a possible option for cases of mild bone loss. 

Zygomatic Implants

This option is designed for severe bone loss in the upper jaw, but they anchor into the cheekbone instead of the jaw. These implants are longer than standard, but can sometimes be used for patients who were previously turned away due to the lack of bone density in their upper jaw.

Next Steps

At The Practice, we take pride in having a team of experts who care. If you’re considering a dental implant, we’d be delighted to address your concerns and help you start the journey to your dream smile. Schedule your personalized consultation at our Franklin, TN, office and take the first step toward restoring your confidence with a trusted team.  Call us at (615) 437-0517 or schedule a virtual consultation today.