Hard tissue grafting
Bone grafting and sinus lift in Downtown Brooklyn
A bone graft rebuilds jawbone that has been lost to extraction, gum disease, or injury so that a dental implant can be placed in the correct position on a stable foundation. A sinus lift is a specific bone graft in the upper back jaw that raises the sinus floor to create the height an implant needs. Both are planned at Brooklyn Periodontics with in-office 3D imaging before anything is scheduled.
Bone is what holds an implant. When there is not enough of it, the honest options are to rebuild it or to change the plan, not to place an implant into a compromised site and hope.
What is bone grafting?
Bone grafting places graft material into a defect, where it acts as a scaffold your own bone grows into and replaces over several months. Depending on the site we use processed human, bovine, or synthetic graft material, and sometimes a membrane or your own growth factors to protect and accelerate healing.
Common versions are socket preservation at the time of an extraction, ridge augmentation to widen or heighten a healed site, and regenerative grafting around a tooth or implant that has lost supporting bone.
What is a sinus lift?
The upper back jaw sits directly below the maxillary sinus. When upper molars have been missing for a while, that bone thins and the sinus expands downward, leaving too little height for an implant.
A sinus lift raises the sinus membrane and places graft material beneath it. A minor lift can often be done through the implant site itself at the same visit. A larger lift is done from the side of the jaw and heals for several months before the implant is placed.
Who is a candidate?
The 3D scan gives an exact measurement of bone height and width. Grafting is typically indicated when:
A tooth is being removed
Socket preservation at the time of extraction keeps the ridge from collapsing and usually avoids a bigger graft later.
The ridge is too narrow or too short
Implants placed into insufficient bone are prone to recession, exposure, and failure. Widening the ridge first protects the result.
Upper molars are missing
Reduced height under the sinus is the most common reason a patient is told they are not a candidate for implants elsewhere.
Bone has been lost around a tooth or implant
Some defects around teeth and implants can be regenerated once the infection is controlled.
A denture no longer fits
Long-term denture wear shrinks the ridge. Rebuilding it makes implant support possible.
How the procedure is performed here
01
3D planning
An in-office CBCT scan measures available bone in three dimensions and shows the sinus, nerve, and adjacent roots. We plan the implant position first, then the graft that supports it.
02
Grafting
Performed under local anesthesia, with sedation available. Graft material and, where needed, a membrane are placed and the site is closed.
03
Healing
Socket grafts mature in about three to four months, larger ridge and sinus grafts in four to nine months, confirmed by a follow-up scan rather than by guesswork.
04
Implant placement
Once the site is measured as stable, the implant is placed, sometimes at the same visit as a minor graft when the bone allows.
Recovery and what to expect
Expect swelling that peaks around day two or three and mild bruising in some cases. Soreness is usually controlled with over-the-counter medication; we prescribe more when a case warrants it.
Soft food for one to two weeks, no smoking, and for sinus grafts no nose blowing, straws, or air travel for a defined period, which we spell out in writing.
You will have both doctors' cell numbers for anything that concerns you during healing.
Why see a periodontist for bone grafting
Regenerative bone surgery is a defined part of periodontal specialty training. Both doctors completed three years of surgical residency at NYU, are board certified in periodontics, and teach and lecture in the specialty.
Because the practice is referral-based and heavily weighted toward revision and salvage cases, we routinely rebuild sites that were grafted or implanted elsewhere. That experience also means we will tell you when a graft is not worth doing.
Alternatives and least invasive options we consider first
Grafting is avoided whenever a shorter or narrower implant, a tilted implant, or a different implant position achieves the same restorative result. Some patients are better served by keeping the natural tooth with periodontal therapy, or by a bridge. We will show you both the graft plan and the no-graft alternative on the scan.
Questions patients ask
Bone grafting and sinus lift questions
- Is a bone graft painful?
- The procedure is done with local anesthesia and is not painful. Afterwards swelling is the main complaint, peaking at two to three days and settling within a week.
- How long does a bone graft take to heal before an implant?
- Socket grafts are usually ready in three to four months. Larger ridge grafts and lateral sinus lifts take four to nine months. We confirm with a scan rather than a calendar.
- Where does the bone come from?
- Most grafts use processed, sterilized donor or synthetic material, which avoids a second surgical site. Your own bone is used when a defect calls for it.
- Is a sinus lift dangerous?
- It is a routine, well-documented procedure when planned with 3D imaging. The sinus membrane is lifted, not entered. Small perforations can occur and are repaired at the same visit.
- Can I have an implant without a bone graft?
- Sometimes yes, by changing implant size, angle, or position. That is exactly what the 3D scan is for, and we will tell you honestly which sites need grafting and which do not.
- Can bone loss from gum disease be regrown?
- Certain defect shapes respond well to regenerative grafting once the infection is controlled. Broad, flat bone loss generally cannot be regrown, and we will say so rather than sell a procedure that will not work.
- Will my insurance cover bone grafting or a sinus lift?
- Coverage varies widely by plan. Our insurance team files the claim electronically as a courtesy, submits the scan and documentation, and gives you a written estimate of your out-of-pocket before you schedule.
- Do you offer sedation?
- Yes. Most grafts are comfortable with local anesthesia alone, and sedation is available for longer or more anxious cases.
- What if my graft fails?
- Grafts occasionally do not take, most often with smoking or an untreated infection. We re-evaluate, treat the cause, and re-graft when appropriate.
- Can you graft a site another office already treated?
- Yes. A substantial part of our practice is revision work on sites grafted or implanted elsewhere, referred by dentists and other specialists.
Related
Dental implants
How implants are planned and placed once the foundation is stable.
All-on-X full arch
Replacing a full arch with four to six implants.
Tooth extraction
Removal with socket preservation so the ridge does not collapse.
Failing dental implant
Bone loss around an existing implant, evaluated and treated.
Told you do not have enough bone for implants?
Bring the scan or let us take a new one. In most cases there is a path, and we will show you the measurements behind it.