Bone grafting and sinus lifts explained
A bone graft or sinus lift on a treatment plan can be a surprise. This guide explains why they are used, what they involve and the questions worth asking.
Why bone comes into it
An implant is held in the jawbone, so it needs enough bone around it in the planned position. After a tooth is lost, the bone that held it often changes shape over time. Gum disease, infection and the shape of a person's jaw can also mean there is less bone than an implant needs in a particular spot.
When that is the case, a dentist may discuss adding bone, choosing a different implant size or position, or a different treatment altogether. This is a clinical judgement made from the examination and imaging, usually a 3D scan.
The main procedures
Socket preservation. When a tooth is removed, graft material is placed in the empty socket to help keep the shape of the bone for a later implant. It is often done at the same appointment as the extraction.
Ridge augmentation. Where the jaw has narrowed or lost height, bone material is added to build it up. Depending on the amount needed, this may be done with the implant or as a separate stage beforehand.
Sinus lift. In the upper jaw, the back teeth sit below the maxillary sinus, an air space in the cheekbone. If there is not enough bone height under the sinus, the dentist can gently raise the sinus lining and place bone material beneath it. There are different techniques, approached through the implant site or from the side, and the choice depends on how much height is needed.
What graft material is made of
Graft material comes from several sources:
- Your own bone, taken from another part of the mouth.
- Donor bone, processed human bone from a tissue bank.
- Animal-derived bone, commonly processed bovine (cattle) bone.
- Synthetic materials, made in a laboratory.
A membrane is often placed over the graft to protect it while it heals. If you have dietary, religious or personal reasons to avoid animal-derived products, tell the dentist. Ask which material they propose, and why.
How grafting changes the timeline
When a graft is done at the same time as the implant, the overall timeline may change little. When the graft must heal first, it commonly adds several months before the implant can be placed, and the implant then has its own healing period. Our guide on how long implant treatment takes puts the stages together.
How grafting appears on a quote
A graft is normally a separate line on the plan, with fees for the procedure, the material and any membrane. Sometimes the need for a graft is only confirmed during surgery, so some plans list it as a possible extra. Ask whether the graft is definite or possible, and what the cost would be if it is needed.
If two plans for the same tooth differ because one includes a graft and the other does not, ask each practitioner to explain their reasoning. That is a normal question.
Questions to ask
- Why is a graft proposed at this site?
- Is it definite, or only possible?
- Will it be done with the implant or as a separate stage?
- Which material will be used?
- How long must it heal before the next stage?
- What does it add to the cost, and how does my medical aid treat it?
Frequently asked questions
Is bone grafting always needed for implants?
No. Many implants are placed without grafting. It depends on the bone at the planned site.
Is a sinus lift a nose operation?
No. It is done through the mouth, in the upper back jaw, to raise the floor of the sinus above the back teeth.
How long does a graft take to heal?
If the graft must heal before the implant, it commonly takes several months. The treating dentist can give a timeline for your case.
Can I choose a non-animal graft material?
Ask the dentist. Several types of material exist, and they can explain which are suitable for your case.