Quick Answer
Is a bone graft always necessary for a dental implant?
No, it is not needed for every implant. At Yeonhap Dental Clinic, we use 3D CBCT to check whether there is a position that secures 2 mm of bone on the cheek side and 1.5 mm on the tongue side around the implant, and apart from grafting the cheek-side gap in immediate front tooth placement after extraction, we do not do a bone graft when this thickness can be secured within the width of the replacement tooth. If the bone falls short of this standard, or if a cheek-side gap forms when a front tooth is placed on the day of extraction, we graft.
When is a bone graft needed for an implant?
It is needed when 2 mm of bone on the cheek side and 1.5 mm on the tongue side cannot be secured within the width of the replacement tooth, such as when bone has shrunk long after an extraction or has been lost to periodontitis. In these cases, the bone must be reinforced for the implant to last. When a front tooth implant is placed on the day of extraction, the gap that forms on the cheek side is filled with graft material. This is because, in the front teeth, if the cheek-side bone is thinner than 2 mm, the gum may appear to recede over time.
How can I tell whether an implant is possible without a bone graft?
On 3D CBCT, we vary the position and angle of placement within the cheek-to-tongue width of the tooth to see whether there is a spot that gives 2 mm and 1.5 mm. For lower molars where the height to the nerve canal is insufficient, we consider short implants 4, 5, or 6 mm long and 5 mm or more in diameter. In a meta-analysis comparing bone augmentation with short implants in atrophic jaws (Yang 2016), implant failures and complications were more frequent in the augmentation group. The criteria are in the short implant column.
What criteria does Yeonhap Dental Clinic use to decide on a bone graft?
Yeonhap Dental Clinic measures bone height, width, and nerve canal position on CT, first looks for a position that gives the reference values (2 mm on the cheek side of the implant, 1.5 mm on the tongue side), and grafts if there is none or if a gap forms on the cheek side because a front tooth implant is placed on the day of extraction. The graft is done on the same day as placement in four steps: making holes in the bone surface (decortication), filling with graft material, covering with a barrier membrane, and fixation. We do not have a separate stage of doing an ordinary bone graft first and then waiting, and the cost is separate. Sinus lifts follow separate criteria. At your consultation, we show you directly on the CT images why a graft is needed. Details are in the bone graft column.
References
Monje A, et al. Influence of buccal bone wall thickness on the peri-implant hard and soft tissue dimensional changes: a systematic review. Clin Oral Implants Res. 2023. Yang J, Cheng Z, Shi B. Augmentation of the alveolar ridge compared with shorter implants in atrophic jaws: a meta-analysis based on randomised controlled trials. Br J Oral Maxillofac Surg. 2016.
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Before Your Visit
This article is general guidance for implant consultations. Whether treatment is possible and the actual cost may change after an oral examination and 3D CBCT diagnosis. If you have discomfort such as pain, swelling, or looseness, please come in for a consultation so we can check.