When a tooth is extracted and an implant is to be placed (either simultaneously or in the future) it is always necessary to complete bone grafting within the residual sockets that are left behind after the roots of the tooth are removed. The shape of the tooth root is always different from the shape of a dental implant and hence there are always residual socket defects (holes) that must be filled in so that there can be excellent contact of the implant to the newly formed bone.

When a tooth is lost and not immediately replaced, the bone reacts to this event by 'shrinking back'. The bone becomes thinner from a width perspective and the bone height is frequently reduced. This process is known as bone resorption. In order to place implants, it is necessary to rebuild the bone width and height through regenerative surgical therapy. Bone grafting of the ridge is almost always required to enable accurate placement of dental implants. The grafting is completed utilizing tissue bank and/or synthetic bone particles combined with collagen membranes. It is a highly predictable procedure.

In the back of the upper jaw bone, dental implants are frequently needed. In order for a dental implant to be successful in this area of the mouth, there must be sufficient bone height and width to connect (integrate) to the dental implant. When the upper back teeth are lost and not replaced, the sinus cavity becomes enlarged destroying any bone that is left behind. This very large sinus is like a "giant air pocket" and not capable of supporting an implant. A procedure known as sinus grafting (sinus lift) is performed to create bone that will ultimately hold the implants within the sinus. Sinus grafting is an extremely common form of bone grafting.