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What is bone grafting and why is it needed?
The basis of implantation: how missing bone is rebuilt
A stable foundation for a lasting and safe dental implant
After a tooth is lost, the jawbone can recede over time. The longer a tooth has been missing, the greater the chance that the width or height of the bone in that area decreases. This matters because a dental implant can only be placed safely if enough bone of adequate quality is available.
The aim of bone grafting is to improve or restore the bone needed for implantation. At the PureDental clinic in Budapest's 2nd district, on Margit körút, we carry out bone grafting with 3D CBCT-based planning, modern bone graft materials and an oral surgical approach. The aim of the treatment is not only that "there is enough bone", but that the implant and the later dental restoration receive a foundation that is stable, well able to bear load and aesthetically suitable in the long term.
Bone grafting may be needed if the jawbone does not have enough bone for the safe placement of an implant. This often develops because of a tooth that has been missing for a long time, gum disease, inflammation, an accident, an earlier difficult tooth extraction, or, in the back of the upper jaw, the proximity of the sinus.
The most common situations:Bone grafting is not necessary before every implant. If enough bone is available, an implant can in many cases be placed without bone grafting. We always make the exact decision on the basis of an examination and, if necessary, a 3D CBCT scan.
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The basis of implantation: how missing bone is rebuilt
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Internal and external sinus lift: when do we use which?
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Bone widening before an implant: when the thickness is not enough
Bone grafting is an oral surgical procedure in which the missing or receded part of the jawbone is built up with bone graft material, the patient's own bone, or a combination of these. The aim is to create bone of the right width, height and stability for the implant.
A tooth root loads the jawbone in a natural way. If a tooth is removed, this load disappears and the bone can gradually recede. This process can be especially pronounced if the tooth has been missing for years, if there was inflammation in the area earlier, or if the patient wore a removable denture.
As the graft material integrates, strong, stable bone is created that safeguards the implants for many years.
With modern, 3D CBCT-based planning we determine exactly where and how much to treat, so the operation causes minimal discomfort.
We use premium-quality bone graft materials (e.g. Bio-Oss®, BoneAlbumin™, a combination of the patient's own bone and a membrane), always adapted to the patient's individual needs.
The new bone not only provides stability for the implants but also restores the natural shape of the gum and comfortable chewing.
It is important to know that bone grafting is a biological healing process. Integration takes time, and success depends on the patient's general health, smoking, oral hygiene, the condition of the tooth-supporting tissues and also on how well the post-operative instructions are followed.
After a tooth is removed, the bone no longer receives the same natural load as when the tooth root was still in place. As a result, the jawbone can gradually begin to atrophy. First the width of the bone often decreases, later its height can change too.
The extent of bone loss varies from person to person. It is influenced by the reason for the extraction, earlier inflammation, gum disease, the patient's age, smoking, oral hygiene, and how much time passes between the extraction and the implant planning.
That is why, before an implant, it is not enough to look only at whether there is "room" in the gap. It also has to be examined whether the bone is right in three dimensions: whether it is wide enough, high enough, and whether the implant can be placed in the right position for the later dental restoration.
Bone grafting is the solution for those whose bone has receded because of missing teeth but who want a lasting, safe foundation for implants. It opens up the possibility again of stable chewing, confident speech and a natural smile.
It is especially recommended if you:The exact type of bone grafting always depends on your anatomical situation. This usually requires a 3D CBCT scan, because it shows in three dimensions in which direction the bone is missing: in width, in height, or towards the sinus.
Bone grafting is not a single procedure. There are several types, and often the implant plan determines which one is needed. Sometimes only a minor bone widening is needed, at other times a sinus lift, bone preservation after a tooth extraction, or a more complex, multi-step bone reconstruction.
Which procedure is needed is always decided on the basis of the 3D CBCT scan. The scan shows to the millimetre how much bone is available and in which direction it is missing. In many cases we combine two procedures. The planned position of the implant and the type of the later dental restoration also influence the choice.
Horizontal bone grafting is needed when the height of the jawbone ridge is still adequate but it is too narrow for an implant to fit in safely. This most often occurs with a long-standing missing tooth, because after an extraction the bone first atrophies in width.
During the procedure we place bone graft material on the side of the narrow bone ridge. This is usually Bio-Oss® or BoneAlbumin™, often mixed with bone chips from the patient's own bone. We cover the area with a membrane, which holds the material in place and keeps the soft tissues away. Within a few months the bone integrates and widens. For a smaller deficit the bone widening can be done in the same session as the implant placement. For a larger deficit we first build up the bone, and the implantation takes place in a second step.
Vertical bone grafting is needed when the jawbone is not high enough. In this case the bone ridge has receded to such an extent that an implant of adequate length cannot be placed. This typically develops after advanced gum disease, a removable denture worn for many years, an accident or an earlier extraction with complications.
Increasing the height of the bone is the most demanding form of bone grafting, because the new bone has to be built "upwards", above the existing bone level. This requires a stable, shape-retaining membrane, so in such cases we often use a non-resorbable Cytoplast® membrane. Healing takes longer, and the implantation typically takes place only in a second session. If the lack of bone height is in the back of the upper jaw, a sinus lift is often the gentler solution.
The sinus is located in the back of the upper jaw, above the molars. After a tooth extraction, the bone in this area shrinks from two directions: from below because of bone atrophy, and from above because the sinus gradually extends lower. That is why only a few millimetres of bone often remain here, which is not enough for an implant.
During a sinus lift we carefully lift the thin mucous membrane that lines the floor of the sinus, and place bone graft material in the space created. The sinus stays intact, only its floor is moved higher. There are two methods:
Closed (internal) sinus lift: we use it when there is still relatively a lot of bone. The lift is done at the site of the implant, through the drilled opening, which makes it gentler. The implant can often be placed in the same session.
Open (external) sinus lift: it is needed when very little bone is left. We open a small "window" in the side wall of the upper jaw, lift the membrane through it and fill the space. In this case the implantation usually follows in a second session after the bone has integrated.
We carry out the procedure under local anaesthesia, and on request it can also be done under general anaesthesia or sedation. The mild swelling that appears afterwards goes down within a few days. During healing you should avoid blowing your nose hard, holding back a sneeze and flying, because these put pressure on the sinus. You will also receive the exact instructions in writing after the operation.
Socket preservation does not replace bone that has already been lost, but prevents bone loss. After the extraction we immediately place bone graft material in the empty tooth socket and seal it with a membrane. This way the bone does not atrophy, keeps its width and height, and a few months later an implant can be placed without a later, larger bone graft.
We recommend this procedure to anyone facing a tooth extraction who would like an implant in its place later. It is worth making this decision before the extraction, because bone preservation can only be done at the same time as the extraction.
Bone grafting always starts with planning. First we examine the gap, the condition of the gums, the bite, the surrounding teeth and the possibility of a later implantation. The most important step of diagnostics and planning is taking a 3D CBCT scan, because it shows exactly the width and height of the bone, the position of the sinus and the course of the nerve canal.
The procedure is carried out under local anaesthesia, so you do not have to feel sharp pain during the operation. For a larger procedure, strong anxiety or a complex implant plan, sedation or general anaesthesia may also come into question, but we always consider this individually.
During the operation we place the planned material in the missing bone area, then, if necessary, cover and stabilise it with a membrane. During the healing period the bone graft material gradually integrates, and through the body's own bone-forming processes a more stable foundation can develop for the implant.
The healing time is usually 3–6 months, but it can be longer for a larger bone graft, a sinus lift or more complex cases. After the bone graft has healed, the implantation can in many cases already be planned or carried out.
In every case we adapt to the patient's individual anatomy. For accurate treatment planning we take a CBCT scan, on the basis of which we determine the type and extent of the bone graft and the ideal choice of materials.
The operation takes place under local anaesthesia (under general anaesthesia on request). We place premium bone graft material in the missing area (e.g. Bio-Oss®, OrthoSera BoneAlbumin™, a combination with the patient's own bone), which we cover with a special membrane (Bio-Gide® or Cytoplast®) for safe healing.
During the healing period the bone graft material gradually integrates and new bone tissue forms, which provides a stable foundation for the implants. This usually takes 3–6 months.
When the bone has integrated properly and is stable, the implantation can be carried out safely, followed by the placement of the final crown or bridge. This way bone grafting guarantees the stability of the implants in the long term.
What is the difference between a sinus lift and bone grafting?
A sinus lift, that is a maxillary sinus augmentation, is one type of bone grafting. Bone grafting is the umbrella term: every procedure in which we rebuild missing jawbone. This can be done by widening or heightening the bone, or by filling the tooth socket after an extraction.
A sinus lift is a special procedure within this, used exclusively in the back of the upper jaw, below the sinus. Here we do not build on top of the bone ridge, but lift the floor of the sinus and place the bone graft material in the space created. In short: every sinus lift is a bone graft, but not every bone graft is a sinus lift.
The choice of bone graft material always depends on the particular clinical situation. The ideal solution is not the same for bone preservation after a small extraction, a lateral bone widening or an open sinus lift. The aim is that the material, the membrane and the surgical technique together create the best possible conditions for healing.
At PureDental we use world-renowned, premium biocompatible materials such as Bio-Oss® or OrthoSera BoneAlbumin™, which resemble human bone in structure, stimulate cell activity and speed up healing.
We always determine the exact choice of material on the basis of the CBCT scan, the type of bone defect, the planned implantation and individual healing factors.
Bio-Oss® is a widely used, biocompatible bone graft material of bovine origin that is extremely similar to human bone in structure, which is why it can serve as a scaffold during bone regeneration.
We often use it for bone grafts before an implant or combined with implantation, and also for sinus lifts. Its advantage is that it is a well-documented, widely used material, especially in situations where maintaining the volume in the longer term is important.
OrthoSera BoneAlbumin™ is a material of human origin (allograft) that is coated with albumin. This albumin stimulates cell activity and speeds up the healing process, so it can be especially advantageous for patients for whom fast and effective regeneration is particularly important.
An autograft, that is bone chips obtained from the patient's own bone, is the most natural form of bone grafting. It contains living cells and growth factors that help the bone integrate faster and more strongly.
Because it is entirely the patient's own tissue, it rules out the risk of rejection. However, in most cases we combine it with other premium bone graft materials (e.g. Bio-Oss®), in order to achieve the safest and most effective regeneration possible.
Whether Bio-Oss®, BoneAlbumin™, the patient's own bone or a combination of these is the best choice is not a question of marketing but a professional decision. We always decide on the basis of the type of bone defect, the planned implantation and the patient's individual situation.
During bone grafting we often also use a membrane. The purpose of the membrane is to protect and stabilise the bone graft material and to help the healing take place in the desired area.
Bio-Gide® is a resorbable membrane that can often be used for smaller and medium bone grafts. Cytoplast® is a non-resorbable membrane that can provide more stable space maintenance in certain larger or more complex cases. We always choose the type of membrane on the basis of the extent and purpose of the procedure.
The price of bone grafting is not a fixed amount, because two procedures are rarely the same. There is a significant difference between bone preservation after an extraction and an open sinus lift. The price is determined mainly by the following factors:
Bone grafting and bone graft materialIndicative prices based on our price list: the surgical fee for bone grafting from €333, bone graft material from €253, harvesting of the patient's own bone €135. Absorbable membrane from €321, non-absorbable Cytoplast® membrane €407; internal sinus lift €311, external sinus lift €676. We give the exact amount in a written quote after the examination and the evaluation of the 3D CBCT scan.
We give you the exact price at the consultation, after evaluating the CBCT scan. You then receive a written, itemised quote with no hidden costs, which includes the bone grafting and the later implantation.
We accept health fund cards and give our pensioner patients a 10% discount.
→ You can find our detailed price list here: puredental.hu/en/prices/
After bone grafting it is normal to have swelling, tightness, mild pain or bruising for a few days. These can usually be managed well with the instructions you receive and, if necessary, with painkillers. After a larger procedure, a sinus lift or a more extensive bone graft, the swelling can be more pronounced and healing also needs more attention.
During the healing period it is especially important to avoid smoking, to keep up good oral hygiene, to attend the check-ups and to make sure the surgical area is not subjected to excessive mechanical load. After a sinus lift, blowing your nose, movements that increase pressure, holding back a sneeze, certain sports and the timing of flying may need special attention. We always give the exact instructions adapted to the particular operation.
If increasing pain, growing swelling, fever, discharge with an unpleasant smell, bleeding or opening of the wound occurs, you should contact the clinic as soon as possible.
Yes, in many cases you can. If, according to the CBCT scan, enough bone of adequate quality is available, the implant can be placed without bone grafting. That is why it is not worth assuming in advance that bone grafting will be needed.
In the case of complete tooth loss, in certain cases the restoration of the whole dental arch on 4 or 6 implants, or a solution planned with tilted implants, may come into question. The aim of these can be, among other things, to make the best possible use of the existing bone, so that in certain cases the need for a larger bone graft can be avoided or reduced.
The exact answer, however, is always given by individual planning. The same solution cannot be used for everyone, because the amount of bone, the position of the sinus, the course of the nerve canal, the bite and the type of the later dental restoration all influence the decision.
We have collected the answers to the questions our patients ask most often about bone grafting.
Professionally reviewed by Dr. Nóra Boka Dentoalveolar surgeon, implantologist
Bone grafting is carried out under local anaesthesia, so you do not have to feel sharp pain during the procedure. After the operation, swelling, tightness, tenderness or bruising can occur for a few days. These are usually natural post-operative symptoms and can be managed well by following the instructions you receive.
The integration of the bone graft material usually takes 3–6 months, but the exact duration depends on the type of procedure, the size of the area rebuilt, the materials used and individual healing. After larger procedures or a sinus lift, a longer healing time may be needed.
In certain cases yes. With smaller bone defects the implant placement and the bone graft may take place at the same time. With greater bone loss, an unfavourable bone shape or lower primary stability it can be safer to proceed in two steps: first the bone graft, then the implantation after healing.
In many cases yes. If enough bone is available, the implant can be placed without bone grafting. In the case of complete tooth loss the All-on-4™ solution can also be an alternative: thanks to the special tilted placement of the implants, bone grafting can be avoided in most cases. What the safe route is in your case, we decide on the basis of the CBCT scan.
The most common procedures: horizontal bone grafting (if the bone is narrow), vertical bone grafting (if the bone is low) and socket preservation (bone preservation after tooth extraction). The choice is always made according to individual CBCT-based planning.
In addition to these, a sinus lift is common in the back of the upper jaw. You can read more about the individual types above, in the section "The types of bone grafting".
A sinus lift, that is a maxillary sinus augmentation, is one type of bone grafting. Bone grafting is an umbrella term for every procedure that rebuilds missing jawbone. Within this, a sinus lift is a procedure used exclusively in the back of the upper jaw, below the sinus, in which we lift the floor of the sinus.
Bone taken from the hip bone is needed very rarely, only in the case of severe, extensive bone deficiency. This can be, for example, major bone loss caused by an accident, tumour surgery or decades-long complete tooth loss. In everyday practice bone graft materials, the patient's own bone taken from the mouth, and the All-on-4™ solution are enough in almost every case.
Bone grafting from the hip bone is a maxillofacial surgical operation performed in hospital conditions under general anaesthesia. If, on the basis of the examination, such a procedure is needed, we refer you to specialist maxillofacial surgical care, and the later implantation can then be carried out with us.
Bone grafting is a routinely performed, safe oral surgical procedure. Like every medical procedure, it can carry risks, but the occurrence of complications is extremely low, especially if the treatment is carried out by an experienced oral surgeon, with premium-quality materials, in a sterile and well-prepared environment.
Possible, temporary symptoms after the procedure:
Rarer but treatable risks:
Overall: bone grafting is a modern and safe procedure that, with proper preparation and expertise, carries minimal risk, while making a successful and lasting dental restoration possible.
Smoking, untreated gum disease, inadequate oral hygiene, poorly controlled diabetes, skipping check-ups and not following the post-operative instructions can all reduce the chances of healing. We go through these factors at the consultation, so that the procedure can take place under the best possible conditions.
Bone grafting and sinus lift are well-researched, predictable procedures of oral surgery. According to the international literature, the long-term survival rate of implants placed in bone prepared this way is above 90%, which approaches that of implants placed in natural bone.
The success is most reduced by smoking, untreated gum disease, poorly controlled diabetes and not following the healing instructions. We go through these in detail at the consultation.
In the first days avoid vigorous cleaning of the wound area and use a chlorhexidine mouthwash instead. After 2–3 days the surrounding area can also be brushed gently with a soft toothbrush. You can usually return to the full oral care routine after 2 weeks.
It can rarely happen that a bone graft heals partly or completely not as expected. The cause can be infection, smoking, loading too early, impaired wound healing or an individual biological factor. In such a case we assess the situation with a check-up and, if necessary, imaging.
In many cases a solution can still be found with a corrective procedure, a different choice of material, a longer healing time or a modified implant plan.
If you would like an implant but have been told earlier that you do not have enough bone, or you have had a long-standing tooth gap, it is worth starting with a thorough consultation based on 3D diagnostics. In many cases bone grafting can create the conditions for implantation, and in other situations an alternative implant or dental restoration solution may also come into question.
At the PureDental clinic in Budapest's 2nd district we help you decide, with a detailed examination, CBCT-based planning and a personalised treatment plan, which path can lead to a stable dental restoration that works in the long term.
Secure a stable foundation for your dental implants with premium bone grafting. Call now or apply online, and we will contact you within 3 hours during opening hours.
Bone grafting in Budapest's 2nd district: bone widening before an implant, sinus lift, bone preservation after tooth extraction, personalised 3D planning and a transparent treatment plan.