When is a bone graft needed for an implant?
It is needed only when the width or height of the bone that will surround the screw is lacking. “Is a bone graft mandatory? What happens if I don’t have one?” When a filling step is added, it can seem like a bigger burden, but some people truly need it and some don’t.
In natural teeth, the periodontal ligament cushions impact, but an implant relies on the bone alone. If the bone is too thin, the screw can’t integrate, and as the surrounding bone shrinks, the gums recede and the screw becomes exposed. If the height is too short, the nerve or the maxillary sinus can be affected. Common cases where a bone graft becomes necessary are:
- A site where a tooth was removed after severe periodontitis had already broken down the bone
- A site left empty for a long time after extraction, where the bone width has shrunk
- A site with little height up to the maxillary sinus, such as the upper molars
- A site where the bone was damaged by root infection or trauma
What if the bone width is too narrow?
We either fill the inner and outer sides so bone remains around the screw, or consider a narrower screw. A narrow screw is easier to place even when the width is small, but it is less durable, so it isn’t often used for molars, which take strong chewing force. We don’t divide every mouth by a single number, such as “below so many mm means a graft no matter what.”
What if the bone height is too short?
We either go without a graft using a short screw, or fill if there isn’t enough. These days there are more screws that can be short, so even when the bone is shorter than average, it is sometimes possible to proceed without a graft. However, there is a limit to how short they can be, so for very short sites we go with filling.
For the upper molars, a sinus lift is added only when the height is lacking, and for the lower molars, the distance to the nerve determines the screw length. Sinus lifts are covered in detail in upper molar implants and sinus lifts.
| What is lacking | Treatment | What we don’t do |
|---|---|---|
| Width | Fill the inner and outer sides, or consider a narrow screw | Insist on narrow screws for molars |
| Height | Short screw; if insufficient, sinus lift or graft | Fill everything based on height alone |
| Both width and height sufficient | Place without a graft | Fill a site that already has enough |
How much does an implant bone graft cost?
Wonjin Dental’s prices for bone grafts and related items are below. They are separate from the cost of the implant itself.
| Item | Cost |
|---|---|
| Simple bone graft | ₩150,000 |
| Complex bone graft | ₩300,000 |
| Sinus lift (crestal approach) | ₩500,000 |
| Sinus lift (lateral approach) | ₩1,000,000 |
| Implant (Osstem SA / BA / SOI) | ₩300,000 / ₩500,000 / ₩800,000 |
As of September 2026. Check other items, such as the abutment and the restoration, in all fees.
How much longer does treatment take with a bone graft?
It takes longer by however long the grafted bone needs to settle, usually adding a few months. The timeline differs between filling at the same time as placement and filling first, waiting, then placing. If a lot is filled or the sinus is lifted, the wait is longer.
How we do it at Wonjin Dental
We look at height, width and distance to the nerve with panoramic and three-dimensional imaging (CT), and point out where and how much is lacking. When filling, we first explain where, how much, and whether it will be done at placement or after a wait. We don’t fill where there is enough; we fill only where it is lacking. If a necessary graft is skipped to save money, the site ends up being reopened later.
Frequently asked questions
Does a bone graft hurt a lot?
It is done under anesthesia, so there is usually little pain during the procedure. The larger the grafted area, the more swelling and discomfort there may be for a few days, which is managed with the prescribed medication and cold compresses.
If the tooth was extracted long ago, do I definitely need a bone graft?
When a site is left empty for a long time, the width has often shrunk, but a graft isn’t always needed. We don’t assume what the bone used to be; we re-measure the width and height that remain now and decide.
What bone graft materials are used?
There is your own bone, processed human bone, processed animal bone, and synthetic material, among others. The choice depends on how much is lacking and where, and we explain the material used at the consultation.
