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Why do I need a dental implant AND a bone graft?

Ok, so your dentist has informed you that your tooth just doesn’t have a good long term prognosis and they feel you should extract it. As part of your post-extraction plan, your dentist has also suggested you get a dental implant and you have agreed that the implant is how you would like to proceed.  Why am I, your oral surgeon, suggesting that you have a bone graft too and what does that entail?  First of all, let me say you made a wise decision.  The implant is one of the most predictable, long term restorative solutions that we have in all of dentistry.  The implant traditionally has been placed after a period of healing following the extraction.  With advancing technology, we can often place the implants at the time of the extraction, reducing your treatment time and decreasing the number of procedures required to restore your missing tooth.

Now about that bone graft.    When a bone graft is done to prepare for dental implants, we call that “Ridge Preservation”.  The bone that we place serves as a way to improve your own body’s ability to heal the socket after the tooth is removed.   Essentially, you already have a way to repair the socket.  The grafting just makes that process more efficient.  If you have elected to delay the implant placement, then the bone not only helps the socket to heal more efficiently and quickly, it also delays bone resorption that naturally occurs once a tooth has been removed.   With the bone graft, in many cases we can return to place the implant 2-3 times quicker than if we had not grafted.  And because we grafted at the time of extraction we have a much better site in which to place the implant because we staved off bone loss.   The old adage here is that it easier to maintain what you already have than it is to try and replace it after it’s lost. If we are able to place the implant at the same time as the extraction, then we have a tooth shaped socket (the space left over after the tooth is removed) in which to place the dental implant.  The implant is often smaller than the tooth was and so there is inevitably space around the implant.  Here, the bone graft serves to help fill in those spaces.  This improves initial implant stability, helps to prevent bone resorption around the implant, and the bone aides to speed up the healing time so that the implant can more quickly become strong enough to place a crown on the implant.  So whether we are preparing to place the implant in the future or we are placing the implant at the time of the extraction, the bone graft helps us accomplish your treatment goals in the most efficient way possible.