Do I Need a Bone Graft?
Why the jawbone shrinks once a tooth has gone, how a graft rebuilds it, what it costs and the alternatives that often make one unnecessary.
Will I Need a Bone Graft Before a Dental Implant?
Often not, and less often than many people assume. The real answer comes from a 3D CT scan of the height, width and density of your bone. Plenty of implants need no graft at all; a small graft is usually added at the same appointment as the implant; and a larger rebuild may have to heal for a few months beforehand. At Peninsula Dentists on Greenwich Peninsula a small graft, membrane included, is from £700 and a large graft from £998. Dr Imran Riaz will tell you at a free consultation whether you need one.
Why the Jawbone Shrinks
Your teeth keep the surrounding bone healthy. Each time you bite, the root passes a little force into the bone, which keeps it dense and strong. Take the tooth away and that stimulus disappears, so the bone gradually remodels and shrinks. The ridge narrows first and then loses height, mostly within twelve months, and it keeps shrinking more slowly after that. An old gap usually means more bone has gone, and a denture pressing on the gum speeds the process up.
So an implant placed soon after a tooth is removed is often simple, while one placed into a gap that has existed for decades may need the bone built back first.
How We Find Out
A standard dental X-ray shows how tall the bone is but not how wide, so decisions based on X-rays alone involve some guesswork. A CT scan on our own scanner (£120), taken at your consultation, builds a 3D picture of the bone and maps the lower-jaw nerve and the upper sinus around it. It tells Dr Riaz whether the existing bone can take an implant as it is, whether adding a little graft at the same time would help, or whether the site needs rebuilding first. He then plans the implant position on the scan and carries it into surgery with a 3D-printed MegaGen R2 guide.
Told You Don't Have Enough Bone?
A CT scan on our own scanner gives you a clear answer, and the implant consultation is free.
What a Graft Involves
A graft adds material so that, once healed, the implant is surrounded by solid bone along its full length. Usually this is a bone substitute: a sterile mineral framework that your own bone gradually grows into, protected by a membrane while it heals. Because it is a substitute, nothing has to be taken from elsewhere in your body.
- Small grafts fill a thin area or a gap next to the implant. They are placed during the implant visit itself, with no extra anaesthetic. From £700, membrane included.
- Larger grafts rebuild a ridge too narrow or too low to hold an implant safely. The graft is placed first and allowed to heal for a few months before the implant goes in. From £998.
- A sinus lift places graft material beneath the floor of the sinus above the upper back teeth, where bone is often thin. Whether you need one, and the fee, is confirmed from your scan in your written plan.
Afterwards, expect a few days of swelling and tenderness that ordinary painkillers handle, and soft food for about a week.
Ways to Avoid a Graft
A graft is not the only option when bone is thin, and it is not always the best one.
- A shorter or narrower implant can work within the bone that remains. Modern designs, including the MegaGen AnyRidge system we use, are made to achieve a firm hold in softer or thinner bone.
- Tilted implants can angle past the sinus or nerve into denser bone. This is exactly why full-arch treatment angles the back implants, and why it seldom needs grafting.
- Placing the implant the day the tooth comes out, where the socket is healthy, preserves much of the bone that would otherwise be lost.
If another clinic has said there is not enough bone, our scan will settle it, and Dr Riaz will explain plainly which route he would take and why.
What Helps a Graft Succeed
- Not smoking. It cuts the blood supply the graft depends on and is the biggest avoidable risk.
- Good control of diabetes. Well-managed diabetes heals normally; poorly managed diabetes does not.
- Healthy gums first. Any gum disease is treated before grafting.
- Careful aftercare: soft food, gentle cleaning and leaving the area alone.
- Attending reviews, so the graft can be checked as it heals.
What It Costs
| Item | Fee |
|---|---|
| Implant consultation | Free |
| CT scan, per arch | £120 |
| Small bone graft, with membrane | From £700 |
| Large bone graft | From £998 |
| Implant and crown, single tooth | From £2,250 |
| Full-arch implants, per arch | From £9,300, CT scan included |
Your written plan shows a graft as a separate line, so its cost is never hidden inside another fee.2 With full-arch treatment, the plan is built to avoid a graft where it can, and routine grafting is already part of the Staged, Same-Day and Premium pathway fees; only more extensive rebuilding is quoted on its own line. Every implant fee we charge is in our implant cost guide.
Questions
This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.