Dental Bone Grafting

Dental bone deterioration is a common problem that can lead to tooth loss. The National Institute of Dental and Craniofacial Research estimates that more than 40 million Americans have lost at least one tooth due to decay, infection, or trauma.

Dental bone grafting is a procedure that can help to reverse this process by restoring lost bone tissue. It is often used with dental implants, which are artificial teeth implanted into the jawbone.

What Is a Dental Bone Graft?

When a tooth is lost, the bone in the jaw that supports that tooth begins to degenerate. A dental bone graft is a surgical procedure to replace the jaw’s missing bone. The graft is typically donated cadaver bone, taken from another part of the body, such as the hip or tibia, or it may be made from synthetic materials. The graft is then implanted into the jawbone to promote new bone growth.

Types of Bone Grafts

There are three main types of bone grafts: autografts, allografts, and xenografts.

  1. Autogenous: This type of graft uses bone from the patient’s body. The most common site for harvesting autogenous bone is the iliac crest, which is the upper part of the hip bone.
  2. Allografts: This type of graft uses bone from a donor. Donated allografts are taken from American cadavers and sterilized using the highest standard of tissue safety.
  3. Xenografts: This type of graft uses bone from a donor animal. Xenografts are rarely used today due to the risk of disease transmission.

Bone Graft Substitutes

Bone graft substitutes are materials used to replace missing bone in a surgical procedure. Many types of bone graft substitutes exist, including synthetic and natural materials. Synthetic materials are manufactured and include substances such as plastics and metals. 

Natural materials from animals or plants include substances such as collagen and bone marrow. Bone graft substitutes promote healing in various surgical procedures, including orthopedic surgeries, dental surgeries, and craniofacial surgeries.

Some examples of bone graft substitutes include:

  • Demineralized Bone Matrix (DBM)/Demineralized Freeze-Dried Bone Allograft (DFDBA)
  • Graft Composites
  • Bone Morphogenetic Proteins

Why Teeth Are So Important for Jaw Bone Health

The bones of the jaw play a vital role in the health of teeth. The roots of teeth are embedded in the jawbone, and the jawbone helps to hold teeth in place. When teeth are lost, the jawbone begins to shrink and weaken. This can lead to problems with biting and chewing and cause the remaining teeth to shift out of position. Dental bone grafting is a procedure that can be used to restore lost bone mass and help preserve the health of teeth.

Results of Teeth and Bone Loss

Tooth loss can have a significant impact on the health of the jawbone. When teeth are lost, the roots that anchor them in place are also lost. This can cause the jawbone to deteriorate and weaken over time. 

The loss of bone mass can lead to several problems, including:

  • Shifting of remaining teeth
  • More wear and tear of the teeth that are remaining
  • Jaw pain
  • Difficulty chewing and speaking
  • TMJ pain
  • Changes in one’s facial appearance

There are several reasons for jaw bone deterioration; these include:

  • Tooth extraction
  • Periodontal disease
  • Trauma
  • Dentures
  • Misaligned or crooked teeth
  • Osteomyelitis
  • Tumors
  • Developmental deformities
  • An enlarged sinus cavity

Tooth Extraction

Tooth extraction is the most common cause of jaw bone deterioration. When a tooth is removed, the root that anchors it in place is also removed. This can cause the bone around the tooth to deteriorate over time.

Periodontal Disease

Periodontal disease is a common problem that can cause significant damage to the teeth and their supporting bone. When the bone around the teeth is lost, it can be difficult or impossible to restore without dental bone grafting.


Trauma to the mouth, such as having a tooth knocked out, can lead to bone loss because there is no longer stimulation to the area. A graft would be place to restore function to the area and to promote new bone growth.


Dentures can cause the jawbone to deteriorate because they sit on top of the gums and do not directly stimulate the underlying bone. Over time, this can lead to a loss of bone volume. With bridgework, the area that spans the gap where the teeth are missing receives no stimulation, resulting in bone loss as well.


Misaligned teeth can leadto uneven pressure on the jaw. The areas of the jaw that are not receiving normal stimulation can deteriorate. 


Osteomyelitis is an infection of the bone that can damage the jawbone. Treatment requires antibiotics and removal of the infected bone. A bone graft may be used to restore bone function and growth. 


Bone grafting is a standard surgical procedure used to fill in gaps in the bone or build up bone mass. When a tumor is removed from the jawbone, it can leave behind a large hole or void. It is often necessary to perform a bone graft to ensure that the jawbone heals properly and that the patient does not experience problems with chewing or speaking.

Developmental Deformities

A dental bone graft can help correct developmental deformities of the jawbone. If the jawbone doesn’t grow properly, this can lead to problems with teeth alignment and chewing. A dental bone graft can help fill in any gaps or defects in the jawbone and can also help stimulate new bone growth. This can help correct problems with the bite and improve a patient’s overall appearance.

An Enlarged Sinus Cavity (Hyperpneumatized Sinus)

Many times there is not enough height of bone in the upper jaw for placement of implants. This can be due to a combination of previous dental extractions as well as an enlarged sinus cavity above. One way to increase the height of bone in this area is to perform a sinus lift procedure using bone graft. This decreases the volume of the sinus cavity but does not have any effect on the development of environmental allergies, your ability to breathe, or create any sinus symptoms. 

The Procedure

Oral surgeons typically perform dental bone grafting procedures. A pre-operative evaluation will be performed to determine the best type of graft for you. Dental x-rays and  a CT scan will be taken to measure the size of the area that needs the bone graft. In many cases the bone graft can be performed in conjunction with a dental extraction, if an extraction is warranted. Once the tooth is extracted, bone graft material is tightly packed into the empty root spaces (i.e. the remaining tooth socket).

Sedation Methods

Since dental bone grafting is a surgical procedure, there are many options for anesthesia.  A local anesthesia is always used for the procedure, but there are additional options for laughing gas and I.V. (intravenous) anesthesia.The type of anesthesia recommended will depend on the individual person and the extent of the procedure being performed.

Post-Operative Care

After a dental bone grafting procedure, there are some things that you will need to do to ensure a successful recovery. Here are a few tips:

1. Keep the area clean. It is recommended that you continue brushing and flossing every day. Decreasing the volume of bacteria and food in your mouth is the best way to ensure that you have a successful outcome.

2. Avoid strenuous activity. You will need to avoid strenuous activity for at least two weeks after surgery. This includes exercise, heavy lifting, and anything else that may cause undue stress on the surgical site.

3. Be gentle with the site of surgery. Avoid heavy mechanical pressure in the area, such as usage of a waterpik. Avoid eating crunchy or hard foods, as this can put stress on the surgical site.

Ridge Augmentation

Ridge augmentation is a type of dental bone graft used to increase the height and width of the jawbone. If you experience bone loss that extends beyond the confines of a single tooth socket, you may require a ridge augmentation. This extent of bone loss can lead to a sunken-in appearance of the gums and a loss of support for the adjacent teeth. A ridge augmentation can reverse any horizontal and vertical jawbone  deformities and prepare the mouth for future dental implants.

Sinus Lift

A dental bone graft is used for a sinus lift surgery. This procedure is used to increase the height of the sinus floor. This surgery is often necessary when placing dental implants in the upper back jaw. The increased height of the sinus floor can provide more support for the implant and help to improve its success rate. The dental bone graft provides new bone that will fuse with the existing bone to create a solid foundation for the implant. Without a proper bone graft, the implant may not be stable and could eventually fail.

Tooth Socket Preservation

When a tooth is extracted, the surrounding bone begins to resorb, meaning that it breaks down and is absorbed by the body. This can cause the jawbone to shrink and change shape over time. To prevent this, a dental bone graft is recommended at the time of extraction to preserve the tooth socket. The graft will keep the socket from shrinking, will protect the bone of the adjacent teeth, and will provide support for future dental implants.

Dental Bone Graft Risks

As with any type of surgery, there are some risks associated with dental bone grafting. The most common risks include:

1. Discomfort

2. Bleeding

3. Swelling

Extremely rare risks can include:

1. Failure of the graft to heal properly

2. Allergic reaction

3. Rejection of the graft 

Despite these risks, dental bone grafting is a safe and effective procedure that can help to improve the success of other dental procedures, such as dental implants. If you are considering a dental bone graft, discuss the risks and benefits with your dentist and surgeon.

Dental Bone Grafting Boulder, CO

If you are considering dental implants or another type of dental procedure that requires a bone graft, contact our team at Foley and Le Oral, Maxillofacial, and Dental Implant Surgery. We have highly skilled and experienced oral surgeons who regularly perform dental bone grafting in Boulder, CO. We will work with you to develop a tailored treatment and recovery plan to meet your individual goals. Contact (303) 444-2255 to schedule a consultation. We will be happy to answer your questions and help you make the best decision for your needs!

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Frequently Asked Questions

Are you awake for dental bone graft?

Your options for anesthesia can be discussed with Dr. Foley and Dr. Le at the time of your consultation. Although local anesthesia is given at the surgical site, you have additional options to have laughing gas, and/or intravenous sedation.  

How long for a dental bone graft to heal?

The healing process for a dental bone graft can vary depending on the graft used and the volume of growth we would like to achieve. However, it typically takes 3-6 months for the bone graft to fuse with the existing bone.

Are dental bone grafts safe?

Dental bone grafts are generally safe, with a success rate of over 95%.

Can I drink alcohol after dental bone graft?

It is best to avoid alcohol for at least one week  after your dental bone graft surgery. Drinking alcohol can increase the risk of bleeding and swelling.

When can I smoke after dental bone graft?

You should avoid smoking for at least 4 weeks after dental bone graft surgery. Smoking can delay the healing process and increase the risk of complications.

Can dental bone grafts be rejected?

There is a small risk that the body will reject the dental bone graft. This is more likely to occur if you smoke or vape post-operatively, are immunocompromised (e.g. undergoing active chemotherapy), have had multiple surgeries in the area of interest, or a history of multiple sensitivities.

Is dental bone grafting painful?

There is mild discomfort and swelling after your dental bone graft surgery. However, this can be controlled with pain medication and minimizing the amount of physical activity (e.g. exercise) you partake in during the first week.

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