Bone grafting for implants (Alveolar bone augmentation (including sinus lift))
A procedure to add or build up bone in the jaw so there is enough to hold a dental implant securely.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Bone grafting builds up jawbone so there is enough to hold a dental implant securely.
- It is usually a step within implant treatment, and can add several months while the graft matures.
- A sinus lift is a common type for the upper back jaw; the main specific risk is tearing the thin sinus lining.
- Smoking, infection and poor healing reduce success, so an experienced clinician and good aftercare matter.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Creates enough bone to place a dental implant securely
People with active gum disease, infection or poor oral hygiene until treated.
Expect swelling, soreness and minor bleeding; swelling often peaks around day two. Use prescribed pain relief, eat soft foods, and follow sinus...
Clear written aftercare, including sinus precautions for a sinus lift.
Expect swelling, soreness and minor bleeding; swelling often peaks around day two. Use prescribed pain relief, eat...
Swelling settles and stitches may be removed at around a week. Most people feel much better and return to normal...
The gum heals over the graft. Continue gentle cleaning and avoid pressure or trauma to the area.
The graft matures into bone. Once it is solid enough, the implant is placed (if not already) or the implant...
What is bone grafting for implants?
A dental implant needs enough solid bone to hold it firmly. If a tooth has been missing for a while, or was lost to gum disease or injury, the jawbone may have shrunk so there is not enough. Bone grafting adds or builds up bone so an implant can be placed.
The graft material may be your own bone, processed donor or animal bone, or a synthetic substitute. It acts as a scaffold that your body gradually replaces with its own bone over several months.
A common type in the upper back jaw is a sinus lift, where the floor of the sinus is gently raised and bone is added beneath it, because the sinus often sits low where the back teeth used to be. Other types build up the width or height of the jaw ridge, or fill a tooth socket at the time of extraction (socket preservation).
Grafting is usually a step within implant treatment, not a treatment on its own. Sometimes it is done first and the implant placed months later; sometimes both are done at the same visit. It adds time, cost and some extra risk, but can make implants possible where they otherwise would not be.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Sinus lift (sinus augmentation)
For the upper back jaw, where the sinus sits low. The sinus floor is gently lifted and bone added beneath it. Can be done through the side of the jaw (external) or up through...
Ridge augmentation
Builds up the width or height of the jaw ridge where bone has shrunk, so an implant of the right size can be placed.
Socket preservation
Bone graft placed into a tooth socket at the time of extraction to limit shrinkage and keep the site ready for a future implant.
Guided bone regeneration
Graft material is covered with a protective membrane to help new bone form in the right place, often done alongside implant placement.
Preparing for your procedure
- Have a full assessment with a GDC-registered dentist or surgeon, including a 3D (CBCT) scan to measure the bone and plan the graft.
- Discuss which type of graft and material is proposed, and whether the implant will be placed at the same time or later.
- Be honest about smoking, which significantly reduces graft and implant success; stopping helps.
- Tell the clinician about sinus problems or allergies (for a sinus lift), diabetes, gum disease, bone medicines and other conditions.
- Have any gum disease or infection treated first.
- Understand the extra healing time the graft needs before the implant can be finished.
- Plan for a day or two of recovery and arrange any prescribed medicines.
What happens
The procedure is usually done under local anaesthetic, sometimes with sedation. The gum is opened to reach the bone. For a sinus lift, the sinus lining is gently lifted and graft material is placed beneath it; for a ridge graft, material is placed where extra bone is needed, often held with a membrane and sometimes small fixings.
The gum is then stitched closed. The procedure usually takes around 30 to 90 minutes depending on the type and amount of grafting. In some cases the implant is placed at the same time; in others the graft is left to mature first.
Afterwards you can expect swelling and soreness for a few days. The graft then needs several months to turn into solid bone before, or while, the implant integrates.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- People with active gum disease, infection or poor oral hygiene until treated.
- Heavy smokers, who have a much higher risk of graft and implant failure.
- People with active or chronic sinus disease considering a sinus lift, until assessed.
- People with poorly controlled diabetes or conditions that impair healing.
- People on some bone medicines (such as bisphosphonates), who need specialist assessment.
Delay or rearrange if…
- You have an active mouth or sinus infection.
- You have a cold or sinus congestion and a sinus lift is planned.
- Your diabetes or another condition is not well controlled.
- You are pregnant and the procedure can reasonably wait.
- You are not yet able to stop smoking or commit to aftercare.
Alternatives to discuss
- A shorter or narrower implant that avoids the need for grafting, where suitable.
- Implants placed in a different position with more bone.
- A conventional bridge or denture instead of an implant.
- Leaving the gap untreated if it does not affect function or health.
- Reassessing after treating gum disease or stopping smoking.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Creates enough bone to place a dental implant securely
- Can make implants possible where there was too little bone
- May allow a better-positioned, longer-lasting implant
- Socket preservation can reduce bone shrinkage after a tooth is removed
- Often done alongside implant placement to save a separate procedure
Risks & complications
- Pain, swelling and bruising for a few days
- Minor bleeding from the gum or, after a sinus lift, the nose
- Soreness and temporary difficulty eating on that side
- Infection of the graft site
- The graft material becoming exposed through the gum
- Part of the graft not taking, needing a repeat or smaller implant
- Temporary numbness of the lip, gum or chin
- Tearing of the sinus lining during a sinus lift, which may need the procedure adjusting or stopping
- Sinus infection (sinusitis) after a sinus lift
- Graft failure needing the material removed
- Lasting numbness from nerve injury
- A lasting opening between the mouth and sinus
Grafting is generally successful, but it adds time and some specific risks. For a sinus lift, the main one is a tear in the thin sinus lining, which is fairly common during surgery and usually managed at the time, but can lead to sinus problems. Infection, graft exposure and the graft not fully taking are the other key risks, and are more likely in smokers and with poor healing. An experienced clinician, careful planning with a 3D scan, and good aftercare reduce these risks.
Published figures to discuss
Bone grafting for implants is generally successful, but outcomes vary with the type of graft, the amount of bone needed, the technique and the individual. For sinus lifts, tearing the sinus lining during surgery is fairly common but usually managed at the time; significant complications such as infection or graft failure are less common. Smoking, infection and poor healing increase the risk. The figures below are drawn from clinical reports and should be treated as guides, not guarantees.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Sinus lining perforation during sinus lift | Commonly reported; roughly 1 in 5 for the external (side) approach and lower for the internal approach in one NHS source | Usually identified and managed during surgery, but can lead to sinus problems or affect the graft. | NHS (Cambridge University Hospitals) — Sinus lift procedurescuh.nhs.ukPublished figure |
| Infection or graft failure (sinus lift) | Low single-figure percentages in clinical reports | More likely in smokers and with poor healing; may need the graft redone or the plan changed. | Sinus augmentation bone grafts for dental implants — clinical outcome (PubMed)pubmed.ncbi.nlm.nih.govSource-linked context |
| Graft resorption or insufficient bone for the planned implant | Recognised risk, higher with larger defects and sinus grafts | A scan after healing may show that the implant plan needs changing or further grafting. | Sinus augmentation bone grafts for dental implants — clinical outcome (PubMed)pubmed.ncbi.nlm.nih.govSource-linked context |
| Numbness after donor-site or jaw surgery | Uncommon, depending on graft source and nerve proximity | Chin, lower jaw and ramus grafts need explicit discussion of lip, chin or tooth sensation. | Sinus augmentation bone grafts for dental implants — clinical outcome (PubMed)pubmed.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery from the surgery itself is usually quick, with swelling and soreness for a few days. The longer wait is for the graft to mature into bone, which takes several months before the implant can be completed.
- Swelling, bruising and soreness for several days
- Minor bleeding from the gum or nose after a sinus lift
- Eating soft foods and chewing on the other side for a while
- A months-long wait while the graft turns into bone
- Mild congestion or pressure after a sinus lift
Aftercare
- Take prescribed pain relief and any antibiotics as directed.
- After a sinus lift, follow sinus precautions: avoid blowing your nose hard, sneeze with your mouth open, and avoid straws if advised.
- Eat soft foods and keep the area clean using the method your clinician recommends.
- Do not smoke, as it greatly reduces graft and implant success.
- Avoid strenuous activity, heavy lifting and air travel for a short period if advised, especially after a sinus lift.
- Attend follow-up so the graft and gum healing can be checked.
- Report any signs of infection or sinus problems promptly.
- Prescribed pain relief and any antibiotics collected
- Sinus precautions understood (for a sinus lift)
- Soft foods for the first days
- Recommended cleaning aids and any mouthwash
- Time off booked and travel plans checked (for a sinus lift)
- A contact route for infection, bleeding or sinus problems
Scars and how they heal
The procedure is done inside the mouth, so there is no visible facial scar. The gum is stitched and heals over the graft. You may have soreness, swelling and bruising of the gum, and after a sinus lift some bruising of the cheek.
⚠ Get urgent help if…
- Increasing pain, swelling, redness or pus at the site (signs of infection)
- Bleeding that does not stop with gentle pressure
- A high temperature or feeling generally unwell
- After a sinus lift: facial or sinus pain, nasal discharge, or air or fluid passing between mouth and nose
- Graft material coming away from the site
- Lasting numbness or tingling in the lip, gum or chin
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A successful graft creates solid bone that can hold an implant securely, which is judged on a scan and at surgery several months later. The aim is to make a well-positioned, lasting implant possible, not to change appearance.
Grafting is usually successful, but it is not guaranteed: the graft can partly fail or become infected, particularly in smokers, and a sinus lining tear can cause sinus problems. Good healing, not smoking and an experienced clinician improve the chances.
Once the graft has matured and an implant is successfully placed, the rebuilt bone supports the implant for the long term, much like natural bone. Studies of sinus grafts with implants report high success when healing goes well. As with any implant, long-term success then depends on oral hygiene, not smoking, control of conditions such as diabetes, and regular dental reviews.
Related tests, treatments or support
Bone grafting is almost always part of implant treatment rather than a standalone procedure. It may be done before implant placement (with months to heal in between) or at the same time. Socket preservation is often done when a tooth is removed to keep a future implant possible. Your clinician should explain the whole sequence, timeline and cost, so the graft is not presented as a surprise extra.
Follow-up & long-term care
You are reviewed after surgery to check healing, with stitches removed at around a week if used. The graft is then monitored, often with a scan, until it is solid enough for the implant to be placed or completed. Regular dental reviews continue once the implant is finished.
- Follow all aftercare and sinus precautions during early healing.
- Attend reviews so the graft and any implant are monitored.
- Do not smoke, to protect the graft and future implant.
- Maintain excellent oral hygiene once the implant is in place.
- Report any infection, bleeding or sinus symptoms promptly.
Repeat, follow-on and what comes next
- If a graft does not fully take, it may need to be redone, or a smaller or differently positioned implant used.
- A torn sinus lining is usually repaired at the time, but occasionally the procedure is staged or postponed.
- Grafting adds months and cost to implant treatment and is not always straightforward.
- Persistent infection may require removing the graft material and healing before trying again.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear written aftercare, including sinus precautions for a sinus lift.
- Prescribed pain relief and antibiotics where appropriate, with instructions.
- Review of healing and a scan to confirm the graft before completing the implant.
- A named contact and route for infection, bleeding or sinus problems.
- An honest plan for what happens if the graft does not fully take.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The type of graft (sinus lift, ridge augmentation, socket preservation) and its complexity
- The graft material and any membrane or fixings used
- Whether it is done with the implant or as a separate procedure
- The experience and qualifications of the dentist or surgeon
- Scans (such as CBCT) and sedation if used
- Clinic location and follow-up included
- The clinician's fee and confirmation they are GDC-registered
- Whether the scan, graft material and membrane are included
- Whether this is separate from, or part of, the implant cost
- Sedation costs if used
- What is covered if the graft does not fully take or needs redoing
- Follow-up appointments and cancellation policy
On the NHS? Bone grafting for implants is rarely funded by the NHS and is usually part of private implant treatment; the NHS may fund it only where there is a specific clinical need.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Presenting the graft as a surprise extra rather than part of the implant plan and cost.
- No discussion of how smoking and healing affect success.
- For a sinus lift, no explanation of sinus tear risk and the precautions afterwards.
- No mention of the extra months needed before the implant is finished.
- No clear policy on what happens, or what it costs, if the graft fails.
Marketing red flags
- Implant 'packages' that hide whether grafting is included or extra.
- Claims of fast 'teeth in a day' that gloss over graft healing time.
- No 3D scan or proper assessment before proposing grafting.
- Pressure to commit quickly or to travel abroad for a cut-price package.
- No discussion of sinus risks for upper-jaw grafting.
Choosing a specialist safely
- Check the surgeon is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the surgeon who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Why do I need a graft, and which type and material are you recommending?
- Will the implant be placed at the same time or later, and what is the full timeline?
- For a sinus lift, what are my sinus risks and the precautions afterwards?
- What are my personal risks given my health and whether I smoke?
- What happens, and what does it cost, if the graft does not fully take?
- What is your experience with this type of grafting, and how often is it successful?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Why do I need a bone graft before an implant?
What is a sinus lift?
Where does the bone come from?
How long before I can have the implant?
Is it available on the NHS?
What if the graft fails?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS (Cambridge University Hospitals) — Sinus lift procedures GDC — Information for patients and the public Oral Health Foundation — Dental implants 15-year study of maxillary sinus augmentation and implants — PMC Sinus augmentation bone grafts for dental implants — clinical outcome (PubMed)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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