Dental Implant Bone Grafting –Do I Need It?

Dental Implant Bone Grafting –Do I Need It?

Dental Implant Bone Grafting –Do I Need It?

This is one of the most common questions I get.

Some of the implant “supercenters” advertise that it is not necessary.  Unfortunately that marketing is misleading.  It is a case-by-case situation that needs to be carefully evaluated.

If the bone is not wide or tall enough for an implant, a bone graft is recommended.  Sure, an implant can just be “put” in into almost no bone.  Is that really helping you?  What most fail to understand is that you are compromising on the essential long-term foundation of the implant, which is the surrounding bone.

What if you were constructing a building that was to be secured by four main posts in the ground?  If you took out one main post, making the building stand on three legs, it would still stand.  If an earthquake happens, would you rather be in the building with four posts or three?  Dental implants are no different; they are subject to extreme forces on a daily basis.


Your bite can generate 300 – 500 psi. Not one day goes by, without a patient breaking a tooth.   Breaking a tooth involves breaking the enamel, which is the hardest structure in the human body!  It is harder than bones!  If you can fracture a tooth, you can damage an implant that does not have enough bone.

Once an implant is in place, the most important thing is that the bone level is maintained.  If an implant or implant bridge is “under-engineered,” with a lack of bone and/or too few implants, the bone will melt away.  Implants that are overloaded are doomed to fail.

Although you may be saving money by avoiding grafting or additional implants, you will pay a steep price in complications as you age.  Dental implants should be looked at as a body part.  Would you want your heart surgeon to skimp on a valve replacement to save some money?

18 Comments

  1. Sharon

    Hi Dr. Amin, I was wondering if age has an effect on the success or failure of a dental bone graft and implant.

    I am 70 years old and currently have numerous implants. I have had these implants for over 25 years. So I have had success in the past.

    I am now faced with a choice of another implant for a newly extracted tooth or just have a new partial made with an extra molar. My husband recently had a bone graft fail and I fear mine will fail also due to my age.

    Thank you for your time.

    June 1, 2019 at 7:04 pm Reply
    1. Ramsey Amin

      Ages not a factor. I just placed 12 implants on the 90-year-old recently and he healed just like anyone else. It has to do with your health and wellness rather than your age. Of course we heal a bit slower at an older age but integration of an implant done well by an experienced provider should have a 1% rate of failure

      June 3, 2019 at 12:10 am Reply
  2. Susan

    Hello,
    My question is simply, if a post is very loose (canine top) after having my implants almost A year and a half ago what do I have to do to fix it? I had the cow bone added when I had the posts put in. It is extremely painful if I try to eat and is even worse to take out teeth and put them in. I have 4 posts on top. Please help.

    December 20, 2018 at 11:17 pm Reply
    1. RamseyAminDDS

      It needs to come out. There is no way to save a loose implant. Sorry

      December 23, 2018 at 6:59 am Reply
  3. Martina

    Can a general dentist perform bone grafts? Is it a core privilege or a special privilege? What kind of training is required?

    October 11, 2016 at 10:19 pm Reply
    1. RamseyAminDDS

      100% without question a general dentist can perform a bone graft. Some general dentists perform bone grafts better than oral surgeons and periodontists! On the other spectrum some regular dentist and specialists are absolutely terrible at it and should not be doing it! It really comes down to the training, experience, judgment and skill of your particular dentist. I do not suggest you see somebody who does dabble some this type of treatment but rather this is their focus.
      I would suggest you see somebody who is been credentialed by the American board of oral Implantology if you’re looking for somebody who is well trained. This is a validation that they are expert in the field.

      October 12, 2016 at 9:21 pm Reply
  4. Michael Cooper

    I had the Canine and upper four tooth removed after they abscessed. The specialist spoke about a bone graft ,but then closely inspected x rays and informed me that we should be able to do the implant without the graft . It’s within the acceptable area when he placed the overlay chart over the top he explained. I’m happy to not have to have the extra surgery but I’m worried about the increased risk of failure and or nerve interference…Should I question his judgement. Actually it is a government dental hospital for students.

    October 28, 2015 at 4:20 am Reply
    1. RamseyAminDDS

      The upper canine tooth and upper front teeth are definitely complex dental implant replacements. They almost always need some type of a bone graft especially in the canine area.

      Skimping on a bone graft will make the outer wall of your bone very thin and susceptible to bone loss in just a few short years.

      Reinforcement bone grafting to thicken this outer wall is very important. As a dental implant specialist, I see many implant complications that could have been avoided by engineering things properly. Saving money now will only cost you a tremendous amount more in the future.

      October 28, 2015 at 10:58 pm Reply
  5. Marcia Houston

    I have had bone grafting with titanium implants..many.
    Now I see receeding gums on both upper sides and can see the implant posts. I am pretty terrified as my insurance will not cover dental. I am SS and part time working older woman. Credit not bad but not really anything of value available. This sounds like a massive expensive undertaking. I doubt credit care would cover enough. Do not want to waste your time if I cannot pay. Implants by Dr Dennis Smiler around 19 years ago. With sinus implant. Very very worried. Implants LOOK beautiful.thank you for your time.

    August 30, 2015 at 3:13 pm Reply
    1. RamseyAminDDS

      After 19 years, some recession may be considered normal. My guess is the type of implants you have were “non-coated or surface treated.” These types of machined implants can have bone loss especially in someone that has a thin gum and bone genetic predilection. This is less common with newer dental implants especially placed with a thick outer wall of bone or even placed by computer guidance. If the implants are stable after 19 years, I guess is nothing needs to be done unless it is cosmetic.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      August 31, 2015 at 12:32 am Reply
  6. collins

    I had a bone graft done there a big of discomfort but not alot of pain. I need to prepare dental implants. For me it was the right choice. But I also went to a second opinion to compare notes. I am glad I did. Have a great week everybody!

    December 6, 2014 at 3:46 pm Reply
  7. ann toole

    good morning,
    please tell me if a dental implant can be done at the same visit or within a couple of weeks of a bone graft?
    or does the bone graft have to heal for months before an implant is put in place?
    how can one tell if a bone graft has been put in place?
    thanks in advance.

    September 23, 2013 at 1:12 pm Reply
    1. Ramsey Amin DDS

      Hi Ann,

      Generally a bone graft would take much longer than two weeks to heal. It seems a bit odd. There is probably a miscommunication.

      Not all types of bone grafts can be seen on xray. In fact most cannot.

      Synthetic materials and cow bone are more easily visible than bone from a human cadaver.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry
      Burbank, California

      September 26, 2013 at 1:51 am Reply
  8. ann toole

    can a second dentist tell, after an implant, if the first dentist did a bone graft?

    September 23, 2013 at 1:01 pm Reply
  9. Margaret Otto

    I’m grateful to you for this excellent website. Can you recommend or tell me how to find a dentist like you 🙂 located in the Chicago, IL area?

    March 30, 2013 at 4:31 am Reply
    1. Ramsey Amin DDS

      Thank you for your kind words. Look on the AAID or ABOI website for someone with the same credentials.

      Ramsey A. Amin, D.D.S.
      Diplomate of the American Board of Oral Implantology /Implant Dentistry
      Fellow-American Academy of Implant Dentistry

      April 1, 2013 at 3:38 pm Reply
  10. Dwayne T.

    Hi Dr. Ramsey Amin,
    You did my implants and bone graft 10 years ago! I moved to Tuscon.
    My dentist said your work is awesome and is holding up perfectly!
    Thank you!!!!!!!!!!!

    June 6, 2011 at 4:22 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!