When is a bone graft needed?
After a tooth is lost, the alveolar bone that supported it is gradually resorbed: without a root, it is no longer stimulated. To place a dental implant, sufficient bone volume is essential. When the bone is insufficient in height or width, a bone graft may be offered. At Cabinet Côté Gare, we assess the available bone volume using 3D imaging (cone beam) and plan a suitable graft: bone taken from yourself (autograft), biomaterials of animal or synthetic origin, depending on the need.
Clinical cases
Cases by Dr Thierry Caro, published with the patients' written consent. Click on a case to see all its photos. Results vary from one person to another.
In which situations is a graft offered?
- After an extraction. The bone is resorbed in the following months. Filling the socket at the time of extraction limits this loss of volume.
- A tooth missing for a long time. The bone ridge has become thinner or lower, and the implant no longer has enough bone to hold.
- An upper tooth at the back of the mouth. The sinus sometimes occupies the space where the implant needs to anchor.
- Periodontitis, an infection or a cyst that have destroyed part of the bone. See the page Periodontics.
A graft is not always necessary. The examination and 3D imaging determine whether the available bone is enough to hold an implant.
Grafting techniques
- Socket filling after extraction. A bone substitute is placed in the socket at the time of extraction to preserve the volume of the bone.
- Onlay graft. Bone is added against a ridge that is too thin or too low, and held in place by small screws. A documented case is shown above on this page.
- Sinus floor elevation (sinus lift). In the upper jaw, material is placed under the sinus membrane to gain bone height.
The choice of technique and material (your own bone, or a substitute of animal or synthetic origin) depends on the area, the amount of bone to be rebuilt and your situation. It is explained to you before the procedure.
A planned outpatient procedure
The bone graft is carried out by Dr Thierry Caro, oral surgeon, under local anaesthetic, as an outpatient procedure. It is planned on the 3D imaging before the day of the procedure. You receive written instructions at the end of the appointment, and post-operative follow-up makes it possible to check the integration of the graft before the implant is placed.
The process, step by step
- Consultation and imaging. Clinical examination, X-rays and 3D imaging (CB-CT) to measure the available bone.
- Treatment plan. The technique, the material, the number of appointments and the quote are presented to you before any treatment.
- Procedure. Under local anaesthetic, at the practice.
- Afterwards. Swelling and moderate discomfort are expected in the first few days. The written instructions specify diet, hygiene of the area and medication.
- Check-ups. An X-ray check verifies that the graft has taken before the implant is placed.
Duration and healing
Depending on the technique used and the amount of bone grafted, 4 to 9 months of healing are generally needed before the implants are placed. In some situations, the graft and the implant placement are done in a single procedure, depending on the volume of bone remaining.
Tell us about your state of health, your tobacco use and your medication at the consultation: they matter for the graft to take.
Bone graft and implants
The graft prepares for the placement of an implant, which is also carried out by Dr Thierry Caro. The implant procedure, aftercare and common questions are on the page Dental implants. 3D imaging is presented on the page Dental X-rays and 3D imaging.
Price
The price depends on the volume of bone to be rebuilt and the material used. The price of 3D imaging is on the page Prices. A detailed treatment plan and a personalised quote are given to you at the first consultation, before any treatment begins.
Frequently asked questions
Is a bone graft painful?
Under local anaesthetic, you do not feel pain during the procedure. Moderate post-operative discomfort can be managed with standard painkillers.
How long before the implant is placed?
Depending on the technique used and the amount of bone grafted, 4 to 9 months of healing are needed before implantation.
What is the success rate of a graft?
Modern techniques and current materials allow a success rate above 95% in patients in good general health.
How much does a bone graft cost?
The price depends on the volume of bone to be rebuilt and the material used. A detailed treatment plan and a personalised quote are given to you at the first consultation, before any treatment begins.
Where does the bone used come from?
Depending on the situation: your own bone, taken from nearby, or a bone substitute of animal or synthetic origin. The choice is explained to you before the procedure.
Is a graft always necessary before an implant?
No. It is used when the available bone is insufficient in height or thickness to hold the implant. The examination and X-ray determine this.
Can the implant be placed on the same day?
In some situations, the graft and the placement are done in a single procedure. This depends on the volume of bone remaining.
Can a graft fail?
Yes, like any procedure. Tobacco, an infection or insufficient hygiene are the factors that weigh most. An X-ray check verifies that the graft has taken before the implant is placed.
Who carries out the bone graft?
Dr Thierry Caro, oral surgeon, at Cabinet Côté Gare in Bussigny. He also places the implants. A case of onlay graft is shown above on this page.
Is 3D imaging necessary before a graft?
The volume of bone is measured with 3D imaging (cone beam), which shows the height and thickness of the bone, the position of the nerves and that of the sinuses. Its price is on the Prices page.
What should I do after a bone graft?
You receive written instructions at the end of the appointment, adapted to your situation. Do not smoke, eat lukewarm and soft food, and protect the treated area. Call 021 218 92 18 if you have bleeding that does not stop, swelling that increases after the third day, pain that gets worse or a fever.
