Bone and soft-tissue grafting
Bone and soft-tissue grafting procedures are used to rebuild, reinforce, or reshape the tissues surrounding natural teeth and dental implants. They may be recommended when gum thickness or bone volume has been reduced by tooth loss, periodontal disease, trauma, infection, or previous dental treatment.
Bone grafting aims to restore sufficient hard-tissue volume to support an implant in an appropriate prosthetic position or to preserve the contour of the jaw after tooth extraction. Soft-tissue procedures, including mucogingival and periodontal plastic surgery, may be used to increase gum thickness, cover selected exposed root surfaces, improve tissue stability, or recreate a more harmonious contour around teeth and implants.
Each procedure is individually planned according to the anatomy, tissue deficiency, aesthetic requirements, and intended final restoration. Clinical examination, photographs, digital impressions, and three-dimensional radiographic imaging are used to evaluate the defect and select the most appropriate and minimally invasive approach.
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Common questions about bone and soft-tissue grafting
01
When is a bone graft recommended?
A bone graft may be recommended when the available bone is insufficient to position a dental implant correctly or provide adequate support around it.
Bone loss may occur after tooth extraction, periodontal disease, infection, trauma, or long-standing tooth absence. In selected cases, grafting may also be performed at the time of extraction to help preserve the dimensions of the ridge. In other cases, it is at the time of implant planning that the procedure is discussed. For example, in cases of no bone available between the jaw and the sinus, a sinus lift procedure can be performed to allow the placement of implants.
The objective is not simply to increase bone volume, but to create suitable conditions for a stable, functional, aesthetic, and maintainable reconstruction.
02
When is a soft-tissue graft recommended?
A soft-tissue graft may be considered when the gums are thin, when tissue volume has been lost, or when gum recession exposes part of a tooth root.
Around dental implants, increasing tissue thickness may help improve the gum contour, support aesthetic integration, facilitate hygiene, and contribute to long-term tissue stability.
The indication depends on the location and extent of the defect, the tissue quality, the smile line, and the functional and aesthetic objectives of treatment.
03
Why are grafting procedures important in the aesthetic zone?
In the aesthetic zone, the final result depends not only on the tooth or implant crown, but also on the volume, thickness, and architecture of the surrounding gums and bone.
Tissue loss may lead to visible depressions, asymmetrical gum levels, exposed roots, elongated-looking teeth, or an unnatural transition between the restoration and the gums.
Careful reconstruction of the hard and soft tissues can help recreate natural gum contours, an appropriate emergence profile, and harmonious integration with the neighbouring teeth and smile.
04
Which materials are used for grafting?
Bone grafting may involve the patient's own bone, processed human- or animal-derived materials, synthetic substitutes, or a combination of these materials. A protective membrane may also be used to stabilise the graft and guide bone regeneration.
Soft-tissue grafts are commonly obtained from another area of the patient's mouth, usually the palate. In selected situations, collagen-based substitutes may be considered to reduce the need for a second surgical site.
The choice of material depends on the type, size, and location of the defect, the treatment objective, and the individual clinical situation.
05
Can grafting be performed at the same time as implant placement?
In many cases, bone or soft-tissue grafting can be performed during the same procedure as implant placement.
This may be possible when the defect is limited and the implant can be positioned with sufficient stability. More extensive deficiencies may require grafting before implant placement, followed by an appropriate healing period.
Pre-surgical three-dimensional imaging and prosthetically driven planning help determine the most suitable treatment sequence and whether simultaneous treatment is predictable.
