What is a dental bone graft?

After a tooth is lost, the jawbone gradually becomes thinner and lower. For an implant to integrate successfully, it must be surrounded by enough bone on every side. When bone is insufficient, the material placed in the deficient area to guide the body in forming new bone is called a bone graft. Patients often call it “bone powder”, but it is usually not a powder at all – it comes as small granules or block pieces.

Grafts are used alone or together with a barrier membrane. When combined with a membrane, the procedure is called guided bone regeneration (GBR).

What should a good graft material do?

Experimental and clinical studies on bone grafts show that no single material can meet every need. The main tasks expected from a graft are:

• Scaffold: Providing a framework into which cells and blood vessels from the surrounding bone can grow (osteoconduction).
• Stimulating bone formation: Accelerating new bone formation through the biological signals it contains (osteoinduction).
• Carrying living cells: Only the patient’s own bone can bring living bone-forming cells with it (osteogenesis).
• Maintaining volume: Preventing the membrane from collapsing and protecting the gained volume against pressure from the overlying soft tissue.
• Safety: Being biocompatible and carrying no risk of immune reaction or disease transmission.

What is an autograft (your own bone)?

An autograft means bone taken from the patient’s own body. Inside the mouth, the most common donor sites are the chin, the back part of the lower jaw (ramus) and the tuberosity at the very back of the upper jaw. For small needs, bone particles collected while preparing the implant site or by scraping the bone surface with a special scraper can also be used. Large reconstructions may require sites outside the mouth, such as the hip bone; this is planned in a hospital setting.

Advantage: The literature describes it as the material with the best-documented ability to stimulate bone formation. When particulated, its surface area increases, so its effect appears faster.

Limitations: It requires a second surgical site, the amount that can be harvested is limited and small particles in particular may resorb more than expected over time.

What is an allograft?

An allograft is human bone processed in tissue banks. Donor bone is prepared sterile, either freeze-dried (FDBA) or additionally demineralised (DFDBA). These processes aim to reduce the risk of immune reaction and disease transmission.

The advantages of allografts are that they do not require a second surgical site and are available in large quantities. However, how clinically effective their growth signals are is still debated, and how widely they are used varies with each country’s regulations.

What is a xenograft (animal-derived graft)?

Xenografts are mostly bone mineral obtained from bovine (cattle) bone with the organic part completely removed (referred to in the literature as DBBM). Some products are of equine, porcine or coral/algae origin. Removing the organic component is designed to eliminate the risk of immune reaction and disease transmission.

The most distinctive feature of bovine mineral is that it resorbs very slowly. Particles have been reported in human biopsies even years after sinus grafting. This becomes an advantage especially when long-term support of the gum contour is desired in the front of the mouth.

What is a synthetic (alloplastic) graft?

These grafts are produced entirely in the laboratory. The most common are hydroxyapatite (HA), beta-tricalcium phosphate (TCP) and biphasic calcium phosphates that mix the two. HA is more permanent, while TCP resorbs quickly; by changing the mixing ratio, the resorption rate can be adjusted. They are a valuable option for patients who do not want human- or animal-derived material.

Bone graft types: comparison table

Which graft is chosen in which situation?

The choice depends on the size and shape of the defect, the aesthetic importance of the area, whether the implant will be placed in the same session and the patient’s general health. A strategy often used in current practice is to place a small amount of autogenous bone close to the implant surface to accelerate bone formation, cover it with a slowly resorbing graft to maintain volume, and cover everything with a membrane.

For socket grafting after tooth extraction, materials that do not require a second surgical site are usually preferred; we cover this topic separately in our socket preservation guide.

What assessments are made before a bone graft?

Graft planning begins with an examination. Gum health, oral hygiene and the condition of neighbouring teeth are assessed; any active gum disease is treated first. Then a 3D CT scan is used to measure the width, height and density of the bone and its distance from anatomical structures such as the sinus or the nerve canal. Your general health, medications and smoking habits are also reviewed, because these factors influence both the choice of graft and the healing time.

At the end of the assessment, your dentist will explain whether the graft will be placed in the same session as the implant or in a separate procedure, which material will be used and the approximate healing time. If the implant is needed in the back of the upper jaw, the required procedure may be a sinus lift.

What should you pay attention to after a graft?

• Apply a cold compress on the first day and avoid hot and hard foods.
• Take the prescribed medication and mouthwash for the recommended period.
• Do not probe the area with your tongue or finger, and do not pull your lip to look at the stitches.
• Do not miss follow-up appointments; stitches are usually removed within 10–14 days.

What are the risks of bone grafting?

• Swelling, bruising and tenderness in the first days (usually temporary).
• Opening of the stitches or early exposure of the membrane, which may increase the risk of infection.
• More resorption of part of the graft than expected, requiring an additional procedure.
• Temporary pain or altered sensation at the site where autogenous bone was harvested.

Smoking, uncontrolled diabetes and some medications that affect bone metabolism can impair healing. It is therefore important to tell your dentist about all the medicines you take.

Frequently asked questions

Related pages

Medically reviewed by: Dr. Dt. Mehmet Fuat BozabaSpecialist in periodontology · September 2026

For an examination and assessment: Message us on WhatsApp or call 0544 289 66 33. Yayla Dental Akademi, Bahçelievler / Istanbul.

Sources: Buser D (ed). 20 Years of Guided Bone Regeneration in Implant Dentistry, 2nd ed. Quintessence Publishing, 2009; Misch CE. Contemporary Implant Dentistry, 3rd ed. Mosby Elsevier, 2008; Hupp JR, Ellis E III, Tucker MR. Contemporary Oral and Maxillofacial Surgery, 6th ed. Elsevier Mosby, 2014.

This article is for information only; a diagnosis and treatment plan can only be made by a dentist after an examination.