Bone grafting and sinus lift: building bone for implants

After a tooth is lost, the jawbone in that area usually shrinks over time. Gum disease, infection, injury or a long period wearing a denture can add to this. In the upper back jaw, the maxillary sinus (an air space above the roots of the back teeth) can also extend downwards, leaving only a thin layer of bone. An implant needs a certain amount of healthy bone around it, so in these situations a dentist may suggest bone augmentation.

Bone augmentation is a group of techniques rather than one procedure. Socket preservation places graft material into a tooth socket at the time of extraction to limit shrinkage. Guided bone regeneration adds graft material, covered by a protective membrane, to build up a thin or narrow ridge, sometimes at the same time as the implant. A block graft fixes a piece of bone onto the jaw where more volume is needed. A sinus lift gently raises the sinus lining and places graft material beneath it, either through a small window in the side of the jaw (lateral approach) or through the implant site itself (crestal or transcrestal approach).

Graft material may come from your own body, from processed human or animal bone, or from synthetic substitutes. Each has advantages and drawbacks, and the choice depends on the defect and the clinician's approach. Grafting is not always necessary: shorter or angled implants, a different implant position, a bridge, a denture or, in severe cases, zygomatic implants may be alternatives. A good clinician will explain why grafting is recommended for you and what the other options are.

Bone grafting or a sinus lift may be suggested for adults who want implants but do not have enough bone in the planned area. A dentist will need to assess you in person with imaging, usually a CBCT scan, before anyone can say whether grafting is needed or which technique suits you.

• A scan shows that the bone is too thin, too narrow or too low for the implant that is planned.
• In the upper back jaw, the sinus sits close to the area where an implant is needed.
• A tooth is about to be extracted and you are planning an implant there later.
• Your gums are healthy, or gum disease has been treated and is stable.
• You can plan for a longer overall timeline, and possibly an extra trip, while the graft heals.

Smoking, poorly controlled diabetes, some medications (including those affecting bone metabolism), previous radiotherapy to the head or neck and existing sinus problems can affect whether grafting is advisable and how well it heals. Tell the clinic about any history of sinusitis or sinus surgery. This page is general information and not a diagnosis.

1. 01

   Remote review of your records

   You share any recent X-rays or scans, photographs and your medical history. A clinic may be able to say whether grafting is likely, but this stays provisional until you have been examined.

2. 02

   Examination and 3D imaging

   The dentist examines you and usually takes a CBCT scan to measure bone height and width, check the sinus and locate nerves. They then explain which technique, if any, they recommend and why.

3. 03

   Grafting surgery

   The graft is placed under local anaesthetic, sometimes with sedation. Depending on the situation, the implant may be placed at the same appointment or in a later, separate surgery.

4. 04

   Healing of the graft

   The graft is given time to mature into bone that can support an implant. This often takes several months and varies with the technique, the size of the defect and your healing. You will usually go home during this time.

5. 05

   Implant placement, if staged

   If the implant was not placed with the graft, a new scan is usually taken and the implant is placed once the bone has healed. A further healing period then follows before the final tooth.

6. 06

   Final crown or bridge

   When the implant has integrated, the abutment and final crown or bridge are fitted, as described in the dental implants guide.

Grafting usually adds time to implant treatment and often adds at least one trip.

When the graft and implant can be placed together, the plan may still involve two main trips. When the graft needs to heal before the implant is placed, three trips spread over many months are common.

Small grafts or a crestal sinus lift can sometimes be done at the same time as the implant. Larger defects or a lateral sinus lift more often need a separate healing period. Ask the clinic to set out every expected appointment, and the gap between them, in writing.

What can change the timeline

• The size and shape of the bone defect
• Which technique is used, and whether the implant can be placed at the same time
• The type of graft material
• How quickly your graft heals
• Your general health, including smoking and conditions such as diabetes
• Any sinus problems that need treatment first

The cost of grafting depends heavily on how much bone needs to be rebuilt and how. These are the main factors behind a clinic's quote.

• The technique, for example socket preservation, guided bone regeneration, a block graft or a sinus lift
• The graft material and any membrane used
• Whether bone is taken from another site in your mouth
• Imaging such as CBCT scans before and after grafting
• Sedation, if you choose or need it
• Whether the implant is placed at the same time or in a separate surgery
• Your travel and accommodation for any extra trip

We do not publish prices on this page. Each clinic sets its own fees and provides an indicative range, which can only be confirmed once a dentist has examined you and reviewed your scans. Ask for a written, itemised plan before you book anything, and check what is and is not included.

Bone grafting and sinus lifts are established procedures, but they are surgery and carry risks of their own. Your clinician should explain these as they apply to you before you consent.

• Swelling, bruising, discomfort and bleeding are common for some days after surgery.
• The graft can become infected, may not heal as planned or may partly fail, which can mean removing it and grafting again or changing the plan.
• During a sinus lift the sinus lining can tear. This is often repaired during surgery, but it can sometimes mean stopping and trying again later.
• Sinus problems, including sinusitis, can develop after a sinus lift and may need treatment with medication or, rarely, further surgery.
• If bone is taken from another site in the mouth, that area can also be sore and, depending on the site, may cause temporary or occasionally lasting numbness.
• Grafts in the lower jaw can affect nearby nerves, causing numbness or tingling in the lip, chin or tongue, which is usually temporary.
• After a sinus lift, flying and pressure changes may not be advisable straight away. Follow your treating clinician's advice on when it is safe to travel.

The first weeks after grafting matter for how well it heals, and many of the instructions are about protecting the area.

• Follow the clinic's instructions on medication, rinsing and diet, and avoid chewing on the grafted area.
• After a sinus lift, avoid blowing your nose hard and sneeze with your mouth open, as advised by your clinician.
• Avoid smoking, which can affect how well the graft heals.
• Do not wear a denture over the area unless your clinician has adjusted it and said it is safe.
• Before you book, agree with the clinic who handles follow-up at home, and seek prompt advice for increasing pain, swelling, fever, discharge or a blocked nose with bad taste.

No verified partner clinics list this treatment yet. Start an assessment and your coordinator will tell you what's available.