Bone graft after tooth extraction: Techniques, alternatives, healing, and more

bone graft after tooth extraction
Following an extraction, the most challenging consequence is bone loss. This happens because, without teeth, the jawbone lacks stimulation from chewing forces, leading to its collapse and hindering the possibility of implant treatment to replace the missing teeth.

To overcome this problem, your dentist may recommend a bone grafting technique during the procedure.

Find out in this article everything you need to know about bone grafting following a tooth extraction.

What does bone grafting after tooth extraction involve?

After checking your teeth, your dentist might suggest a bone graft during extraction to keep your jawbone volume intact. This technique, called socket preservation, involves placing bone or synthetic material in the empty socket where the extracted tooth used to be.

Your dentist will likely recommend it if you have thin tissues (thin bone and gums) or if your bone is already weak and prone to breaking down during the healing process.

In short, a dental bone graft is used to prevent bone loss, restore and keep bone volume, and strengthen the jawbone so that you can receive an implant later on.

Now, different types of bone grafts can be used:

Types of dental bone grafts


Autograft: Bone is taken from another part of your body, usually from the back of your mouth, if the amount needed is small or moderate. However, if a large amount is needed, bone can be taken from extra-oral sites such as the skull or iliac crest.


Allograft: Bone is taken from another person, usually a cadaver. Before being used, it is carefully processed to remove any infectious factors or antigens.


Xenograft: The bone used for the graft comes from another species. Like allografts, they also undergo processing before being used in your jaw.


Synthetic material: This is a bone-like biomaterial that can serve the same purpose as other types of bone grafts.

What happens to the jawbone after a tooth extraction?

Bone resorption 12 months after tooth extraction

The alveolar bone begins to shrink progressively, losing 32% of its width at 3 months and 29-63 % at 6-7 months, according to one study. Bone loss then continues at a slower rate in the following year.

As for the teeth bordering the extraction site, they will start shifting to fill the space left. The tooth in the opposite jaw will move vertically, while the neighboring teeth will tilt horizontally.

As the opposing tooth migrates, it may lose its bony and gum support, and suffer severe recession. It may then become longer, looser, and eventually fall out.

teeth bordering the extraction site start to shift

When you have fewer teeth, you may have to rely on your remaining teeth to do more of the chewing work. This can lead to difficulties in eating and chewing, limiting your dietary diversity.

Losing teeth can put extra strain on the bone and remaining teeth, leading to more wear and tear and increased vulnerability to damage and decay over time.

Furthermore, your facial features may change. The soft tissues that were previously supported by your teeth may lose their elasticity, causing sagging and premature aging. This can impact your self-esteem and confidence.

Socket preservation can help you save a significant amount of bone

Studies have shown that adding a bone graft after tooth extraction reduces bone loss by approximately 1.89 mm in width and up to 2.07 mm in height compared to extraction alone (2).

So, socket preservation is a beneficial technique that slows bone resorption and maintains the shape and volume of the jawbone, facilitating future implant placement. In doing so, it helps you avoid complex and costly additional procedures later on.

Autogenous bone grafting (bone from your own body) has always been considered the gold standard for augmentation procedures. It is the only graft that contains living cells, allowing for new bone formation and, therefore, better regeneration.

However, the downside is that it requires a second surgical site. In addition, many studies have found that it is associated with a higher risk of resorption in socket preservation.

For this reason, allografts (bone material from a donor) are the most commonly used for this procedure today. Although they do not contain living cells, allografts still produce good results.

Socket preservation: The procedure

Here are the typical steps involved in the socket preservation procedure:

  1. Examination and Preparation: The dentist performs a thorough clinical and radiographic examination of the tooth to determine whether extraction is necessary.

  2. Extraction: The tooth is then extracted under local anaesthetic. The removal process is carried out as gently as possible to avoid damaging the surrounding bone and tissue.

  3. Socket Cleaning: Once the tooth is removed, the dentist cleans the empty socket of any debris, remnants or damaged tissue.

  4. Bone Graft Placement: The dentist then places the bone grafting material in the empty socket.

  5. Membrane Placement: A membrane is placed over the bone graft material to protect it and optimize the healing process.

  6. Closing the wound: The surgical site is then closed with sutures to hold the bone graft in place and promote optimal healing.

What to expect?

After the socket preservation procedure, it's normal to experience some postoperative effects, such as pain, swelling, and bleeding for the first few days.

You can manage these symptoms with over-the-counter painkillers and antibiotics as prescribed by your dentist.

During this period, avoid smoking, drinking through a straw, or eating hard or crunchy foods for several days after the procedure. Instead, opt for soft, warm foods.

Complete healing can take several months. After a few weeks, your gums will begin to return to their normal appearance, but it will take a few months for the bone to fully mature and be ready to receive an implant.

Typically, after four months, your dentist will perform a clinical and x-ray examination to assess the healing process. If your tissues have completely healed and matured, your dentist will give you the green light to proceed to the next step: implant placement.

Immediate dental implant placement: A quick and effective alternative

Instead of waiting for the socket to heal over a long period (4 to 6 months), there is a quick and convenient alternative. We call it immediate implant placement.

It is defined as the placement of an implant into the socket immediately after the extraction.

Immediate implant placement can offer numerous benefits. Firstly, it can reduce the total treatment time, as the dental implant is placed at the same time as the tooth extraction. This means that you won't have to wait for the socket to heal before getting an implant.

In addition, immediate implant placement preserves more of the natural gum tissue and bone and prevents it from collapsing.

However, it's important to know that not all patients are suitable candidates for this option. It depends on factors such as the quality and quantity of the remaining bone and the location of the tooth being extracted. A thorough examination by a qualified dentist is necessary to determine if this technique is appropriate for you.

  1. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans https://onlinelibrary.wiley.com/doi/10.1111/j.1600-0501.2011.02375.x
  2. Effect of Alveolar Ridge Preservation after Tooth Extraction https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293706/
  3. Alveolar Ridge and Socket Preservation Techniques for Implant Therapy https://decisionsindentistry.com/article/alveolar-ridge-and-socket-preservation-techniques-for-implant-therapy/
  4. Extraction socket preservation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783174/
  5. Comparison Study of the Histomorphometric Results after Socket Preservation https://www.mdpi.com/1660-4601/18/14/7451
  6. The socket-shield technique and immediate implant placement https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6128121/
  7. Which is the best choice after tooth extraction, immediate implant placement or delayed placement with alveolar ridge preservation? https://www.sciencedirect.com/science/article/abs/pii/S1010518219303968