Do You Need a Bone Graft Before Getting Dental Implants?

A dental implant surgery is a dental procedure designed to replace missing teeth. Dental implants are essentially posts and screws that are inserted into your jawbone, that can then be fitted with a dental crown or prosthesis.

It can be helpful to think of dental implants as artificial tooth roots. Similar to the natural roots of a tooth, implants need to be embedded within the jawbone to fuse properly. This way they can anchor the tooth safely and provide enough support to withstand a lot of forces during chewing and eating.

When done properly, dental implants are an excellent option for the replacement of missing teeth and are designed to be permanent (1).

Therefore it’s very important that the thickness of the bone is enough to be able to provide this support for the dental implant (2) to last such a long time. To ensure that there is enough support, sometimes a bone graft (bone transplant) is required in the jaw.

Do You Need a Bone Graft Before Getting Dental Implants?

What is a bone graft?

Dental bone grafting is a procedure that inserts bone tissue in order to gradually increases the bone density and thickness in the jaw.

There are several options to achieve this. The most common process usually involves inserting a bone graft within the socket of an extracted tooth, which over time promotes bone growth and healing – consequently increasing the density of the jawbone.

There are several sources where the bone graft can come from (3):

  • The bone material itself can be removed from other places from your own body (natural bone graft)
  • Bone tissue extracted from another species such as bovine (Xenograft).
  • It can be made of a synthetic bone graft material, such as Hydroxyapatite (Alloplastic grafts).

Why will I need a bone graft to get a Dental Implant?

After a tooth has been extracted, the bone around the socket where the tooth was begins to disintegrate over time. This is known as bone resorption.

So much bone loss happens after a tooth extraction that around 80% of the outer-layer of bone surrounding the socket of an extracted tooth is eventually lost (4).

If you decide to get a dental implant to replace a missing tooth, your dentist will have to examine and measure the thickness of your jawbone where the implant will be placed.

They may then decide that you will need to get a bone graft if your jawbone is not thick enough and the density of the bone is not sufficient.

Who needs to get a bone graft before a Dental Implant?

The older you are, the more prone to bone resorption you will be. This is because the body will begin to absorb bone as a source of calcium if it’s no longer needed to support any teeth that have been extracted.

People with active gum disease or a previous dental abscess or infection may already be suffering from some bone resorption to a degree, and may require a bone graft to get a dental implant (5).

Regular smokers will also most likely require a bone graft. This is because the inhalation of smoke has been linked with the failure of fusion of dental implants (6). Smoking has also been shown to increase the chances of resorption and failure of bone grafts (7).

Healthy individuals with no nutritional deficiencies or gum disease, who visit their dentist twice a year may not require a bone graft before getting dental implants.

How do I know if I need a bone graft for Dental Implants?

In order to determine whether you will need a bone graft for a dental implant or not, you’ll need to be examined by your dentist or oral surgeon.

During this consultation, your dentist will most likely request to further examine your station through 3D-imagery such as taking a panoramic X-ray or most probably a CT scan.

The CT scan will create a 3D image of your jawbone and will give your dentist a much clearer view, allowing them to measure the thickness of your jawbone in order to determine whether you’ll need a bone graft or not (8).

When do I need to get a bone graft for a Dental Implant?

When you need to get a bone graft is determined by how much thickness of bone you need.

For cases of very thin jawbones that require a large increase in bone density, the bone graft can be done several months before the intended dental implant surgery.

Cases requiring minor bone grafting can be done simultaneously at the same time of the dental implant surgery (9).

Sometimes your dentist may suggest you get a bone graft immediately after a tooth extraction. This is known as a post-extraction bone graft.

If you plan on getting dental implants, getting a post-extraction bone graft is a very good option. It allows the bone to heal quickly, prevents any complications from the extraction, and prepares the socket to receive a dental implant at any time in the future (10).


Written by Dr. Khaled Mahmoud

Khaled Mahmoud completed his dental education and obtained his Bachelor of Dental Surgery (BDS) in 2017. His interests lie in cosmetic dentistry and non-surgical facial aesthetics. He is active in dental research, contemporary cosmetic materials and techniques, and has been a member of numerous public health outreach programs.