- Your own bone, processed bone or a synthetic material
- Healing usually takes 3–6 months and can take longer in some cases
- Usually done in a single session under local anaesthetic
A bone graft means placing bone, or a material that stands in for bone, in an area where the jawbone has become too thin or too short to hold an implant. The material is not a permanent filler but a scaffold: over the following months your body builds its own bone onto it, and most of the material is gradually replaced by new bone.
Most patients first come across grafting when an implant is being planned. This page is about the procedure itself: which material, which technique, healing and what comes afterwards.
Why is there not enough bone?
The most common reason is the time that has passed since a tooth was extracted; bone with no tooth in it gradually recedes. Advanced gum disease, pressure from a denture worn for many years, jaw cysts, trauma and difficult extractions also cause bone loss. At the back of the upper jaw, the sinus can expand downwards and reduce the height of the bone.
If an implant is placed despite the missing bone, part of its surface may be left exposed on one side. Over time the gum recedes there, the metal colour of the implant shows through, and the area around it becomes harder to clean; on front teeth this is a direct aesthetic problem. The aim of a graft is to surround the implant with bone of sufficient thickness on every side.
Where does the graft material come from?
| Material | Source | What to know |
|---|---|---|
| Autograft | Your own bone, usually from the same area, the chin or the angle of the jaw | Gives the strongest biological response; if a large amount is needed, a second surgical site is opened |
| Allograft | Human bone processed and sterilised by a tissue bank | Does not need a second surgical site |
| Xenograft | Bone mineral, usually of bovine origin, with the organic part removed | Dissolves slowly and holds the volume gained for a long time; one of the most commonly used |
| Synthetic (alloplast) | Calcium phosphate-based materials made in a laboratory | An option for people who do not want material of biological origin |
To hold the graft in place and stop the gum from growing into it, a thin membrane is often placed over it; most of these are collagen membranes that dissolve on their own within months. Materials are often mixed. You are entitled to ask which one has been chosen and why.
Which technique is used when?
- Socket preservation. A graft is placed in the socket at the moment the tooth is extracted. It largely prevents the bone from collapsing; this is the smallest and most predictable graft.
- Guided bone regeneration. To thicken a narrow ridge of bone, granular graft material and a membrane are used together. If the deficit is small, it is done in the same session as the implant; if it is larger, as a separate stage.
- Block graft. For larger losses, a piece of bone — usually taken from your own jaw — is fixed to the deficient area with small screws.
- Sinus floor elevation. When there is not enough height at the back of the upper jaw, the sinus membrane is lifted and graft material is placed beneath it; details are on the sinus lift page.
How long does the new bone take to form?
A graft's conversion into bone cannot be hurried. Approximate times are:
- Socket preservation: usually 3–6 months before the implant, depending on the material used.
- Graft in the same session as the implant: no separate wait is added, but fitting a tooth on the implant may be delayed by a few months.
- Graft as a separate stage, or block graft: usually 4–6 months before the implant; longer for large losses, especially where height has to be gained.
During this time a visible gap is usually not left empty; you wear a temporary tooth or denture, adjusted so that it does not press on the graft.
What is the procedure like, and what happens afterwards?
A graft is usually placed in a single session under local anaesthetic; you usually feel no pain during the procedure. Socket preservation adds only a few minutes to an extraction; a block graft or extensive regeneration takes longer.
Swelling peaks on the second or third day and then goes down; there may be bruising on your face. Seeing a few small graft granules in your mouth in the first days is common. Stitches are usually removed within 7–14 days. If your dentist has prescribed antibiotics or a mouthwash, use them for the full recommended period, even if you feel better. During this time, do not chew on the treated area, do not probe it with your tongue or fingers, do not rinse vigorously on the first day, and do not smoke. If you wear a denture, do not put it in until your dentist has adjusted it so that it does not press on the graft.
Swelling that increases after the third day, a foul-smelling discharge, a fever, or the membrane or graft becoming visible needs checking: let us know straight away, and if you are not in İzmir, have it seen by a local dentist. If swelling spreads rapidly across your face, or you have difficulty swallowing or breathing, seek emergency care without waiting.
Can a graft be avoided?
Sometimes, yes. In suitable cases, short or narrow implants fit into the existing bone. In full-arch treatment, plans such as All-on-4 can bypass areas that would need grafting by placing the back implants at an angle. A denture is also a valid option.
Some factors lower the success rate of a graft: smoking, uncontrolled diabetes, certain medicines used for osteoporosis, and a history of radiotherapy to the jaw. Be sure to mention these at the examination. The cost depends on the size of the graft, the material, whether a membrane is used and the technique; you receive a written, itemised quote after the examination. At our clinic in İzmir we always decide on grafting from the CBCT scan, together with your implant plan.
Common questions
Is a bone graft painful?
The procedure is done under local anaesthetic, and you usually feel no pain during it. Swelling and tenderness are expected for the next two or three days and can usually be controlled with ordinary painkillers. With a block graft or a large area, this period can last a few days longer.
Is graft material of animal origin safe?
These materials are processed to remove the organic part and then sterilised, leaving the mineral framework of the bone. They have been widely used in dentistry for many years. If you would rather not have it for religious or personal reasons, tell us; there are alternatives such as synthetic material or your own bone.
What happens if the graft does not take?
Part or all of the graft can be lost; the most common causes are infection, the membrane becoming exposed, and smoking. In that case the graft can be repeated once the area has healed, or the plan can be changed. That is why check-ups matter: if a problem is spotted early, most of the graft can often be saved.
Can I wear my denture after a graft?
Not until the inside of the denture has been adjusted so that it does not press on the graft. Sometimes you will be asked not to wear it at all for the first few days. Your dentist will tell you when and how to wear it; do not try to sand down or adjust the denture yourself.
I smoke. Can I still have a graft?
Yes, but smoking markedly reduces the chance of the graft taking. The right thing is not to smoke before the procedure or during healing. If you cannot stop, let us talk about it openly; sometimes the plan can be steered towards one that needs less grafting.
Small granules are coming out of my mouth. Is that normal?
Losing a few small graft granules in the first days is common and usually not a problem. If a lot of granules are coming out, if the membrane or graft is visible, or if there is a bad smell or discharge, have it checked: contact us, and see a local dentist if you are not in İzmir. If you have a fever, swelling spreading across your face or difficulty swallowing, seek emergency care without waiting.
Not sure if this is right for you?
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