Rebuilding the foundation for successful, long-lasting dental implants
Dental implants require a sufficient volume and density of jawbone to be placed safely and to integrate successfully. For patients who have lost bone through tooth loss, gum disease, trauma or the passage of time, there may not initially be enough bone present to support an implant.
Bone grafting is a clinical procedure in which bone or bone substitute material is added to an area of the jaw where volume is inadequate. Over a healing period, this material supports the growth of new bone, restoring the foundation that makes dental implant placement possible.
At Ashtree House Dental, we offer bone grafting procedures as part of our dental implant services. We welcome patients from Wooburn Green, Beaconsfield, High Wycombe, Flackwell Heath and surrounding areas. A thorough assessment, including appropriate radiographic imaging — often including a CBCT scan — is always required before any bone augmentation procedure is planned.
When a tooth is lost or extracted, the bone that previously surrounded and supported its root begins to change. Without the stimulation provided by a functioning tooth root, the surrounding alveolar bone (the ridge of bone that housed the roots) starts to reduce in both height and width — a process known as bone resorption.
The timeline of bone loss:
Why this matters for dental implants: A dental implant is a titanium post placed into the jawbone. Its stability — and its ability to bear the load of a crown or bridge — depends on there being sufficient bone surrounding it.
If the bone is too narrow, too shallow, or of insufficient density, an implant cannot be placed safely, or is at significantly increased risk of failure.
In addition, when multiple teeth are missing or bone loss has been long-standing, the reduced jaw profile can affect the shape of the face, creating a sunken or aged appearance over time.
Bone grafting aims to restore this lost volume, creating the conditions in which implant placement can be carried out successfully.
Bone grafting — also referred to as bone augmentation — is the process of adding bone or bone substitute material to an area of the jaw to increase its volume and create a suitable foundation for dental implant placement.
The graft material serves as a scaffold that stimulates the body to produce new bone cells. Over a healing period of several months, the patient’s own new bone gradually replaces or integrates with the graft material, resulting in a denser, more voluminous jaw ridge.
Bone grafting is not a single, fixed procedure — there are several techniques, each suited to different clinical situations and degrees of bone loss. Your dentist will assess which approach is most appropriate for your individual case.
Bone grafting procedures can use several types of material, each with different characteristics and considerations:
Bone harvested from another site in the patient’s own body — typically from within the mouth (such as the chin, the back of the lower jaw, or the area behind wisdom teeth). For more extensive grafts, bone may occasionally be taken from elsewhere.
Advantages: Contains living bone cells (osteoblasts) and natural growth factors, making it highly biologically active. Generally considered the most effective graft material from a biological standpoint.
Considerations: Requires a second surgical site, which adds to procedural complexity and recovery. The amount of bone available from intra-oral donor sites is limited.
Processed bone from a human donor, obtained from a regulated bone bank. The bone undergoes rigorous screening and processing to remove cellular material, leaving a safe and clinically proven scaffold material.
Advantages: Avoids the need for a second surgical site. Well-established and widely used in dental bone augmentation with a long clinical track record.
Considerations: Some patients may have concerns about donor-origin material. Your dentist will discuss this with you.
Most commonly derived from bovine (cow) bone mineral, which is processed and sterilised to remove all organic components. The remaining mineral matrix closely resembles human bone structure and acts as an effective scaffold for new bone growth.
Advantages: Widely researched and used in implant dentistry. Provides good structural support for new bone formation. Avoids a second surgical site.
Considerations: Derived from animal sources — patients with concerns about this will be offered alternative materials.
Entirely laboratory-produced materials — most commonly beta-tricalcium phosphate (β-TCP), hydroxyapatite, or combinations of the two. These materials are fully synthetic and carry no biological donor considerations.
Advantages: No ethical or biological source concerns. Predictable, consistent composition.
Considerations: Generally considered less biologically active than autogenous bone, though well-suited to many augmentation scenarios, often in combination with other materials.
In practice, a combination of graft materials is often used — for example, autogenous bone mixed with xenograft or synthetic material. This allows the biological activity of the patient’s own bone cells to be combined with the volume and structural support provided by substitute materials. Your dentist will explain the rationale for any combined approach recommended for your case.
Bone grafting is not a single operation — the specific technique used depends on the location, extent and nature of the bone deficit. The main approaches used in preparation for dental implants are:
When it is used: At the time of tooth extraction, before a gap has time to form.
When a tooth is extracted, a large proportion of the bone volume loss associated with tooth loss can be reduced or prevented by placing graft material into the socket immediately after extraction. This is called socket preservation or ridge preservation.
The graft material fills the socket and, covered with a resorbable membrane, supports bone formation as healing takes place. The result is a more stable and voluminous ridge that is better suited to implant placement.
Socket preservation is one of the most predictable forms of bone augmentation and, because it is carried out at the time of extraction, can shorten the overall implant treatment timeline compared to grafting a socket that has already healed.
Key points: – Carried out at the time of tooth extraction — no separate surgical visit required – Significantly reduces bone loss that would otherwise occur after extraction – Simplifies subsequent implant placement in many cases – Healing period of three to six months typically required before implant placement
When it is used: Where the existing jaw ridge is too narrow or too shallow to accommodate an implant, and socket preservation was not carried out at the time of extraction.
Where bone loss has already occurred, a localised bone graft is placed to rebuild the ridge height or width at the proposed implant site. This may involve placing particulate graft material against the ridge and covering it with a resorbable or non-resorbable membrane to protect the graft during healing.
This approach is used for single or multiple missing tooth sites where the bone deficit is relatively localised.
When it is used: To augment a defined area of bone, often in conjunction with implant placement or as a preparatory procedure.
Guided Bone Regeneration is a technique in which a barrier membrane is placed over the graft material. This membrane physically prevents faster-growing soft tissue cells from occupying the space, allowing slower-growing bone cells to fill it instead — a principle known as guided tissue regeneration.
The membrane may be: – Resorbable — gradually breaks down on its own over weeks to months, without requiring removal – Non-resorbable — provides stronger support but requires a second procedure to remove once bone formation is complete
GBR is one of the most well-researched and widely used augmentation techniques in implant dentistry. It is often combined with socket preservation or ridge augmentation procedures.
When it is used: Where a larger, three-dimensional volume of bone is required — typically where significant height and width deficiency exists.
In cases of more extensive bone loss, a solid block of bone (most commonly autogenous — the patient’s own bone) is harvested and secured to the deficient area of the jaw with small titanium screws or fixation. The block graft is then surrounded with particulate graft material and covered with a membrane.
Block grafting is a more complex procedure than particulate grafting and generally requires a longer healing period before implant placement. Because autogenous block bone is commonly used, a second surgical (donor) site within the mouth is required.
When it is used: Where the jaw ridge is of adequate height but insufficient width for implant placement.
In some cases, the jaw ridge is narrow but has adequate height. A ridge splitting or ridge expansion technique can be used to gradually widen the ridge using specialist instruments, with graft material placed into the expanded space to maintain the width. Implants may sometimes be placed at the same time as the ridge expansion.
The type and extent of bone grafting required depends entirely on the clinical situation — specifically the location, volume and pattern of bone loss, and the number and position of implants being planned.
This assessment requires clinical examination and CBCT (cone beam CT) imaging. A CBCT scan provides a three-dimensional view of your jaw, allowing precise measurement of bone height, width and density at each proposed implant site, and accurate planning of both the grafting and implant procedures.
Your dentist will review this information and explain clearly what is required before any treatment is planned. A full written treatment plan and cost estimate is always provided before you proceed.
Bone grafting may be considered if:
Bone grafting may not be appropriate, or additional assessment is needed, if you:
This list is not exhaustive. A full medical and dental history review, together with CBCT imaging, is always required before any bone grafting procedure is planned. We will always provide clear, honest advice about whether bone grafting is a realistic and appropriate option in your individual case.
Your dentist will review your dental and medical history, examine your teeth and gums, and take a CBCT scan to assess the available bone volume at each proposed implant site. The CBCT scan also helps identify any anatomical structures (such as nerves or the sinus) that will influence the planning of both the grafting and implant procedures.
Following the assessment, your dentist will explain what bone grafting is recommended, which technique is most appropriate, the sequence of treatment, and the expected timeline. A full written cost plan is provided.
Any active gum disease or oral infection must be identified and treated before bone grafting proceeds.
Your dentist will provide specific pre-operative instructions relevant to your planned procedure. These may include advice on medications, dietary preparation, oral hygiene, and guidance on smoking cessation where applicable. Prescribed antimicrobials or anti-inflammatory medications may be advised.
Bone grafting is performed under local anaesthetic. Conscious sedation is available for patients who are anxious about surgery and is warmly offered where appropriate.
The specific procedure will depend on the type of graft planned. Your dentist will explain what is involved before the appointment. You will be given full written post-operative instructions before you leave.
Most bone grafting procedures within the mouth are manageable as day-case procedures, and most patients are able to return to normal activities within a few days.
Some swelling, tenderness and bruising is expected following bone grafting surgery, particularly in the first two to three days. The degree of post-operative discomfort depends on the extent of the procedure — more complex grafts involving a separate donor site will have a more involved recovery.
Important post-operative guidance typically includes: – Avoid disturbing the surgical site — do not prod, probe or rinse vigorously for the first 24 hours – Follow the specific dietary guidance provided — soft foods are usually recommended for the first week or more – Maintain gentle oral hygiene, avoiding the graft site as directed – Take any prescribed medication as directed – Avoid smoking — this is one of the most significant factors affecting graft healing and implant success – Avoid strenuous exercise for several days – Attend all scheduled post-operative review appointments
If you experience signs of infection (increasing pain, swelling, fever, discharge), please contact our team promptly.
The graft material requires a healing period during which your own new bone gradually forms around and through the graft scaffold. The duration of this period depends on the type and extent of the graft:
A follow-up CBCT scan is taken at the appropriate point to confirm that sufficient new bone has formed before implant placement proceeds.
Once the CBCT confirms adequate bone volume and quality, implant placement is carried out. In some cases — particularly socket preservation combined with an appropriate ridge — implant placement may be performed alongside or shortly after the graft procedure.
Following implant integration, your new crown, bridge or prosthesis is attached. Your dentist will confirm the fit, bite and appearance before final placement.
In some cases, yes. Whether grafting and implant placement can be carried out simultaneously depends on the type and extent of the graft required:
Your dentist will advise based on your individual clinical situation.
Because bone grafting requires time for new bone to form before implants can be placed — and implants themselves require time to integrate — treatment timelines involving bone augmentation are longer than straightforward implant cases.
As a broad guide: – Simple socket preservation followed by implant placement and restoration: approximately nine to fourteen months – More extensive ridge augmentation followed by implant placement: approximately twelve to twenty months or longer
Your dentist will provide a personalised estimated timeline during your consultation.
Costs vary considerably depending on the type and extent of grafting required, the material used, and whether the procedure is combined with other treatment such as implant placement. We always provide a detailed written cost estimate before any treatment begins. Flexible finance options may be available. Please contact our team to discuss your individual situation.
Bone grafting is a significant procedure. Choosing the right clinical team is essential. Here is what you can expect from us:
Clinician-led treatment — your bone grafting procedure is planned and delivered by an experienced clinician, ensuring clinical quality and safety at every stage.
Thorough consultations — we take time to understand your concerns, assess your suitability carefully, and answer all of your questions before any treatment is planned.
Personalised treatment planning — every treatment plan is tailored to your individual circumstances, anatomy and goals. No two patients are the same, and our recommendations reflect that.
Honest advice — we will always tell you honestly whether a treatment is suitable for you, discuss alternatives where relevant, and provide a full written cost plan before anything begins.
Ongoing aftercare and support — we provide written aftercare guidance and remain available to answer questions after your treatment. Regular reviews and maintenance appointments are encouraged.
If you have been told you may not have sufficient bone for dental implants, or if you would like to find out whether bone grafting could make implant treatment possible for you, we encourage you to get in touch.
Our team in Wooburn Green, near Beaconsfield, High Wycombe and Flackwell Heath will carry out a thorough assessment and give you clear, honest guidance on your options — with no obligation to proceed.
We always provide a full written cost plan before treatment begins and will take the time to make sure you fully understand what is involved.
Bone grafting for dental implants is a procedure in which bone or bone substitute material is added to an area of the jaw where there is insufficient bone volume to place an implant safely. Over a healing period, new bone grows into and around the graft material, creating a stronger and more voluminous foundation for implant placement.
The procedure is performed under local anaesthetic, so you should not feel pain during surgery. Post-operative soreness, swelling and bruising are expected, particularly in the first few days after surgery. Most patients manage this well with prescribed or over-the-counter pain relief. The degree of post-operative discomfort is generally proportional to the extent of the procedure.
Healing times vary depending on the type and volume of graft. Socket preservation typically requires three to six months before implant placement. More extensive augmentation procedures may require four to nine months or longer. Your dentist will give you a personalised estimate.
This depends on the type of graft material used and what is most appropriate for your case. Your own bone (autogenous graft) is biologically the most active material, but requires a second surgical site. Donor, animal-derived, or synthetic materials are widely used alternatives that avoid this. Your dentist will explain the options and their rationale so you can make an informed choice.
Possibly, but active periodontal (gum) disease must be treated, stabilised and confirmed to be under good control before bone grafting is considered. Continuing gum disease around an implant or graft site is associated with high failure rates. Your dentist will assess your periodontal status as part of the consultation process.
In many cases, yes — bone grafting can open up implant options for patients who were initially assessed as unsuitable due to insufficient bone. However, the outcome of grafting is not guaranteed, and not all cases are suitable for augmentation. The only way to determine whether you may be a candidate is through a full assessment including CBCT imaging.
Smoking significantly impairs wound healing, reduces blood supply to the graft site, and is one of the most important factors associated with graft failure and implant complications. We strongly advise patients to stop smoking before and after any bone grafting procedure. Your dentist will discuss this with you honestly during your consultation.
Most patients take one to three days off work following a bone grafting procedure, depending on the extent of the surgery and their occupation. More complex procedures involving a separate donor site may require a longer period of recovery. Your dentist will advise based on your planned treatment.
Bone grafting procedures in implant dentistry have a well-established track record when appropriate patient selection and surgical technique are applied. Success is influenced by patient health, compliance with post-operative care instructions, smoking status, and the extent of augmentation required. Your dentist will discuss realistic expectations during your consultation.
