Bone Grafting and Sinus Lifts for Dental Implants

Why bone disappears, and why that matters

Bone in the jaw exists to hold teeth. When a tooth comes out, the bone that surrounded it stops receiving the load it was built for, and the body begins taking it back. Most of that loss happens in the first year after extraction, and it continues slowly for as long as the gap stays empty. A conventional denture does not stop it; resting on the ridge, it tends to accelerate it, which is why a denture that fitted well five years ago rocks today.

The practical consequence is that an implant needs a certain volume of bone in a certain place to be stable, and a ridge that has been empty for a decade may not have it. That is the problem grafting solves: rebuilding enough structure for a fixture to hold.

It is worth saying plainly that this is a reason to act rather than wait. The question at a consultation is rarely whether anything can be done — something almost always can — but how much reconstruction it now takes.

When a graft can be designed around instead

The instinct, looking at a resorbed ridge, is to rebuild it. The better first question is whether the implant can be placed somewhere the bone already is.

In the upper jaw the usable bone is usually at the front, ahead of the sinus. An implant placed vertically at the back runs into the sinus and needs a lift; the same implant tilted forward at thirty to forty-five degrees can engage that anterior bone along its length, skip the sinus entirely, and still support a tooth at the back of the arch through an angled abutment. That is the mechanism behind the protocol Dr. Paulo Maló’s group published in 2003, and it is why a great many patients who were quoted a graft elsewhere do not need one.

It does not work for everyone. Where the bone is too narrow, too short or too soft in every direction, tilting buys nothing and the honest answer is that grafting or a zygomatic approach is required. The distinction is not a judgement call made across a desk — it is read off the scan.

Grafting and the all-inclusive price

Our arch prices are all-inclusive and we mean it literally: the figure covers the CBCT scan, the sedation, extraction of remaining teeth, the implants, the abutments and the final teeth. Routine grafting is inside that figure too. If your scan shows you need one, the number does not move.

There is one published exception, and it is published because it is a genuinely different operation: zygomatic and pterygoid cases carry a $10,000 add-on over either arch price.

This matters when you are comparing quotes. A low headline figure from another practice very often excludes grafting, and grafting is exactly the thing that gets discovered after a scan — which is to say, after you have committed. If you are collecting prices, the question worth asking each one is: does this number include extractions, sedation, grafting and the final teeth, or only some of them?

Malo bridge pricing is $17,500 per arch through 31 December 2026 and $25,000 per arch from 1 January 2027. Terms.

Bone grafting and sinus lift FAQ