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A bone graft rebuilds jawbone that is too thin, too short or too soft to hold a dental implant, and roughly half of all implant cases need one in some form. The right type depends on where the bone is missing and why: a small graft at the time of extraction, a ridge that has to be widened or raised, or a sinus lift to add height under the upper back teeth. This guide covers the main types, what the procedure involves, how long healing takes, and what it costs.
Reviewed by Dr. David Basar, DDS, Advanced Smile Dentistry, Toms River, NJ. Updated November 2026.
This article is part of our complete dental implants guide, which covers the implant procedure itself; here the focus is on rebuilding bone before or during that process.
Why does bone loss happen, and who needs a graft?
Bone around a tooth is kept in shape by the tooth itself. Once a tooth is gone, the jaw has no reason to maintain that ridge, and it begins to shrink, fastest in the first few months and more slowly for years afterward. Long-term denture wear, gum disease and old extractions left to heal on their own are the most common reasons patients arrive at an implant consultation with less bone than an implant needs. Smoking and uncontrolled diabetes also reduce bone quality and slow healing. A 3D cone-beam CT scan measures the exact height and width available and is how your dentist decides whether a graft is needed at all, a smaller graft will do, or a shorter or angled implant can avoid grafting entirely.
What are the main types of bone grafting for dental implants?
Four approaches cover almost every case, and most patients need only one.
Socket preservation (alveolar ridge preservation). Placed into the socket right after a tooth is extracted, this is the smallest and most common graft. It fills the space the root leaves behind so the ridge does not collapse while you decide on an implant, which matters because untreated sockets lose roughly 2mm of width within months. A 2019 systematic review and meta-analysis in the Journal of Clinical Periodontology, covering 22 randomized trials, found that socket grafting reduced horizontal bone loss by about 2mm compared with letting the socket heal on its own, with the largest benefit in sites that already had a thin outer bone wall.
Ridge augmentation. For a ridge that has already narrowed or flattened, usually because a tooth was lost years ago and never grafted, this rebuilds width (horizontal augmentation) or height (vertical augmentation, the more demanding of the two) using grafting material held in place with a membrane or a titanium mesh. It is the graft most associated with longer healing times because more volume has to mature before an implant can be placed in it.
Sinus lift (sinus floor augmentation). Upper back teeth sit close to the maxillary sinus, and once those teeth are lost the sinus floor can drop lower, leaving too little bone above it for a standard implant. A sinus lift adds graft material beneath the sinus membrane through either a small window in the side of the jaw (lateral window, for larger lifts) or a narrower channel through the implant site itself (crestal, for smaller lifts, sometimes done the same day as implant placement). A 2008 systematic review in the Journal of Clinical Periodontology, covering 48 studies and over 12,000 implants, reported 3-year implant survival around 90% overall after sinus floor elevation, rising to roughly 98% for rough-surface implants placed with membrane coverage over the lateral window, a reminder that technique and implant choice matter as much as the graft itself.
Block or guided bone regeneration (GBR). Reserved for more significant defects, this uses a larger block of graft material, often shaped to the defect and protected by a membrane, to rebuild a ridge that socket grafting or standard augmentation cannot. It is the least common of the four and typically means a longer healing period before implants go in.
What materials are used in a bone graft?
| Material | Source | Typical use |
|---|---|---|
| Autograft | Your own bone, usually from the jaw or chin | Larger ridge or block grafts needing the fastest, most reliable integration |
| Allograft | Donor bone from a tissue bank, processed and sterilized | Socket grafts and moderate ridge augmentation; avoids a second surgical site |
| Xenograft | Processed bone mineral, most often bovine | Socket preservation and sinus lifts, often combined with a membrane |
| Synthetic (alloplast) | Lab-made calcium phosphate or similar mineral | Smaller defects where a fully synthetic option is preferred |
Most sockets and sinus lifts today use allograft or xenograft material rather than bone taken from another part of your own body, which is why a second surgical site is the exception rather than the rule. Your dentist chooses the material based on the size of the defect, how much time you have before the implant, and personal preference.
What happens during the bone grafting procedure?
A socket graft placed at extraction adds only minutes to that visit: the graft material goes into the fresh socket, sometimes under a collagen plug or small membrane, and the gum is closed over it. A standalone ridge augmentation or sinus lift is its own appointment, usually done under local anesthesia with sedation available, and takes 30 to 90 minutes depending on size. The gum is opened, the graft material is placed and shaped, a membrane is laid over it where needed to keep the material in place while it matures, and the gum is closed with sutures that are either removed or dissolve on their own. Most patients describe the discomfort afterward as similar to or slightly more than a tooth extraction, managed with over-the-counter pain relievers for a few days.
How long does bone graft recovery take?
| Graft type | Initial healing (soft tissue) | Time before implant placement |
|---|---|---|
| Socket preservation | 1 to 2 weeks | 3 to 4 months |
| Ridge augmentation (horizontal) | 2 to 3 weeks | 4 to 6 months |
| Ridge augmentation (vertical) / block graft | 2 to 3 weeks | 6 to 9 months |
| Sinus lift | 1 to 2 weeks | 4 to 9 months, depending on how much new bone height is needed |
The gum heals in days to weeks; the graft itself needs months to turn into bone the implant can rely on. A small sinus lift or socket graft is sometimes combined with implant placement on the same day, when there is enough existing bone to stabilize the implant while the graft matures around it. Larger lifts and augmentations are staged: graft first, implant months later, once a follow-up scan confirms the bone is dense enough.
Does a bone graft add time to the overall implant process?
Yes, and this is the most common reason an implant timeline runs longer than a patient expected. Without grafting, a single implant often takes three to six months from extraction to final crown. Add a socket graft and the timeline extends by roughly the healing window above; add a ridge augmentation or sinus lift and the whole process can run nine to twelve months. The upside is a more stable, longer-lasting result: placing an implant into inadequate bone without grafting first is a leading cause of early implant failure, so the extra months are what the long-term success numbers are actually built on.
How much does bone grafting cost?
In New Jersey, bone grafting runs roughly $550 to $5,150 per site, with a small socket graft at the time of extraction at the low end and a ridge augmentation or sinus lift at the high end; this is billed separately from the implant, abutment and crown. Dental insurance sometimes covers a portion of a medically necessary graft (CDT code D7953 for a socket graft, separate codes for sinus augmentation and ridge augmentation), though coverage varies by plan and is worth confirming before treatment. Our New Jersey dental implant cost guide breaks down how grafting fits into the total cost of a finished tooth.
What are the risks, and how successful are bone grafts for implants?
Bone grafting for implants is a well established, predictable procedure, and complications are uncommon. The most frequently seen issues are minor swelling and bruising, a graft that resorbs more than planned and needs a second smaller graft, infection at the site, and, specifically with sinus lifts, a perforation of the sinus membrane during surgery, which in most cases is repaired the same day without changing the outcome. A 3D scan before surgery is what lets your dentist see the sinus floor, nerve position and bone thickness in advance and plan around them rather than discover them mid-procedure. Reported survival for implants placed after sinus augmentation runs close to 90% at three years overall, and higher with favorable technique and implant choice, broadly in line with survival for implants placed in native bone.
How Advanced Smile Dentistry approaches bone grafting
Dr. David Basar is a general dentist with a focus on dental implants, trained at NYU College of Dentistry. At Advanced Smile Dentistry in Toms River, every implant case starts with a complimentary 3D cone-beam CT scan, which shows exactly how much bone is available and whether grafting, a shorter implant, or an angled approach is the right fit for your case. [VERIFY: whether socket, ridge and sinus-lift grafting are all performed in-office at ASD or whether some are referred, and to whom] Straightforward socket grafts are routinely handled at the time of extraction; cases needing a larger ridge augmentation or sinus lift are planned and either treated here or coordinated with a specialist, with one written plan covering every phase.
Next step
A 3D scan is the only way to know whether your case needs a graft, and if so, which kind. Advanced Smile Dentistry offers a complimentary scan and consultation at 2224 Route 37 East, Toms River, NJ 08753; call (732) 608-6478 or book online.
Frequently asked questions
Do I need a bone graft before getting a dental implant?
Only if a 3D scan shows your jaw does not have enough bone height or width to support an implant on its own. Many patients, especially those who treat a missing tooth soon after losing it, need no graft at all.
How long does bone graft recovery take before an implant can be placed?
A small socket graft typically needs 3 to 4 months to mature; a ridge augmentation or sinus lift can take 4 to 9 months, depending on how much bone is being rebuilt.
Is a sinus lift the same as a bone graft?
A sinus lift is one specific type of bone graft, used in the upper back jaw to add height under the maxillary sinus before placing implants there.
Does bone grafting hurt?
Most patients describe recovery as similar to, or slightly more involved than, a tooth extraction, with swelling and soreness managed by over-the-counter pain relievers for a few days.
How much does a bone graft for a dental implant cost?
In New Jersey, roughly $550 to $5,150 per site depending on the type, billed separately from the implant, abutment and crown.
Can an implant be placed on the same day as a bone graft?
Sometimes, for a small socket graft or a minor sinus lift where enough existing bone is present to stabilize the implant while the graft heals around it. Larger grafts are usually staged, with the implant placed months later.
Sources
- Avila-Ortiz G, et al. Efficacy of alveolar ridge preservation: A systematic review and meta-analysis. Journal of Clinical Periodontology. 2019;46(Suppl 21):195-223.
- Pjetursson BE, Tan WC, Zwahlen M, Lang NP. A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Journal of Clinical Periodontology. 2008;35(Suppl 8):216-240.
- American Academy of Periodontology. Bone grafting and guided bone regeneration. perio.org
- American Dental Association, CDT coding reference (D7953 and related grafting codes).