Bone Graft for Dental Implants: Types, Healing Time and Risks

A bone graft adds bone where the jaw is too thin or too short to hold a dental implant. Recovery from the surgery itself takes about a week, but the graft needs at least 3 months to heal, and a large graft can need 9 to 12 months before the implant goes in (Cleveland Clinic). Implants placed in grafted bone appear to last about as well as implants in natural bone, though long-term studies are few (Oral Health & Preventive Dentistry, 2024).

Why you might need a bone graft

An implant is a titanium or ceramic post that has to be surrounded by enough bone to hold firm. When a tooth is lost, the bone that held it starts to shrink. A review of human studies found that, 6 months after an extraction, the ridge had lost 29% to 63% of its width and 11% to 22% of its height. Most of the loss happened in the first 3 to 6 months (Clinical Oral Implants Research, 2012).

So the longer a gap has been empty, the more likely a graft is needed. Other common reasons include gum disease, an infection, an injury, or a sinus that sits low over the upper back teeth (Cleveland Clinic). Grafting is common: Cleveland Clinic cites an estimate of about 2.2 million dental bone grafts a year worldwide.

Types of bone graft material

A graft works like a scaffold. Your own body slowly grows new bone into it (Cleveland Clinic).

Source for the types: Cleveland Clinic. Is your own bone better? A 2014 meta-analysis found no proof of that. Implant survival was similar with bone substitutes and with the patient's own bone, both in sinus grafts and in ridge grafts (European Journal of Oral Implantology). The authors note the studies did not describe defect size well, so the surgeon's choice for your case still matters.

Common kinds of grafting procedures

• Socket graft (ridge preservation). Graft material goes into the socket right after a tooth is pulled, to limit shrinking. A 2021 Cochrane review found that animal-bone grafts reduced the loss of ridge width by about 1.2 mm and height by about 1.4 mm after 6 months compared with letting the socket heal on its own. But the evidence was of very low certainty. The review found no clear difference in whether patients later needed more grafting or whether implants failed (Cochrane).
• Ridge augmentation. The surgeon rebuilds the width or height of a ridge that has already shrunk, usually covering the graft with a protective membrane (Cleveland Clinic).
• Sinus lift. Bone is added under the floor of the sinus above the upper back teeth (Cleveland Clinic). It has its own recovery rules, such as care with nose-blowing, which we cover in a separate article on sinus lift recovery.

Graft and implant at the same time, or in stages?

Surgeons either place the implant in the same surgery as the graft, or graft first and place the implant once the graft has healed. A 2013 review found reported success rates of 61.5% to 100% for implants placed at the same time as the graft and 75% to 98% for implants placed later. The authors called the staged approach more predictable, but the studies were few and the data only "indicative" (International Journal of Oral and Maxillofacial Surgery).

What the procedure and recovery are like

Most grafts are done with local numbing, with sedation as an option. The surgeon opens the gum, places the graft, often covers it with a membrane, and closes with stitches. Most people report little to no pain (Cleveland Clinic).

Source: Cleveland Clinic. Avoid smoking and vaping, spitting, and swishing hard. Cleveland Clinic also notes a time limit the other way: once the graft has healed, the implant should go in within about 6 to 12 months, or the new bone starts to shrink again.

Risks and signs of a failed graft

Bone grafting is generally safe. Possible complications include infection, nerve damage, heavy bleeding and problems with anesthesia (Cleveland Clinic). Failure is more likely in people who smoke or have certain health conditions. Warning signs include:

• pain or swelling that gets worse after the first week
• pus or drainage from the site
• gums pulling back from the teeth
• no gain in bone on follow-up scans

Call the surgeon for a fever of 101°F or higher, rising swelling, pus or severe pain (Cleveland Clinic).

Do implants in grafted bone last?

A 2024 review looked for studies that followed implants in grafted and non-grafted bone for at least 10 years. It found only three. Survival ranged from 91.6% to 100%, and the authors judged it similar for both groups. They also said better studies are needed (Oral Health & Preventive Dentistry). For the bigger picture on lifespan, see how long dental implants last.

Cost and insurance

A graft adds to the cost of an implant; see our dental implant cost guide. Original Medicare does not cover most dental care, including implants, though some Medicare Advantage plans offer dental benefits (Medicare.gov). Check your plan's details before you book.

If you are getting implants abroad

A bone graft is often what turns a one-trip plan into two or three trips. Points to settle before you go:

• Ask for a 3D scan (CBCT) plan up front. Ask the clinic to say, before you book flights, whether you need a graft, what kind, and whether the implant can go in on the same day.
• Plan the gap. If the graft is staged, your second trip may be 3 to 12 months later (Cleveland Clinic). Ask who checks the graft in between.
• Get records. Ask for the graft material and brand, membrane type, scans and surgery notes. A U.S. dentist will need them if there is a problem at home.
• Know who handles a failed graft. Ask what happens if the graft does not take, and whether a redo is included.

Questions to ask about your graft

1. Why do I need a graft, and what do my scans show?
2. Which material will you use, and why that one for me?
3. Will the implant go in the same day or later? If later, how long?
4. What will you do if the graft does not take?

Our dental implants in Mexico guide covers trip planning, and the question checklist helps you compare clinics.

Related reading: Sinus Lift Recovery: Day-by-Day Timeline and What to Avoid, Dental Implant Pain: What Is Normal and When to Worry.