Not every thin ridge needs a graft, and not every graft means six months of waiting — two measurements on a CBCT slice settle the question in advance.
An implant of four millimetres diameter wants at least one and a half millimetres of bone on the cheek side and the same on the tongue side, so the ridge needs to be around seven millimetres wide. Height matters just as much: in the lower jaw we keep a two millimetre safety margin above the nerve canal. Those two figures, measured on a cross-sectional CBCT slice, decide whether you need a graft at all.
A ridge loses much of its width in the first six months after an extraction, and most of that loss is the thin outer plate of bone. Filling the socket with graft granules and a membrane on the day the tooth comes out keeps the shape, costs a fraction of a later reconstruction and adds no extra trip. If a tooth is coming out and an implant is planned, this is the cheapest decision available.
Small defects are handled with granules and a resorbable membrane at the same time as the implant, so nothing is added to the timeline. Larger horizontal deficits are staged: graft first, implant four to six months later. Severe collapse may need a block of bone taken from the jaw angle and fixed with screws, which is real surgery with real morbidity and should never be presented as routine.
Narrow implants, shorter implants and the angled geometry of an All-on-4 all exist precisely to avoid grafting, and in the right anatomy they work. Some quotes list a graft on every case because it inflates the invoice by a predictable amount. Ask any clinic to show you the CBCT slice with the millimetre measurement on it. In our Temos-accredited unit in Şişli that image goes out with the written plan.
Often yes. If the implant is stable in existing bone and the defect around it is small and contained, granules and a membrane go in at the same appointment. If the implant would have no bone to grip, grafting first is the only honest sequence.
The granules are heated and processed until only the mineral crystal structure remains, with no protein and therefore no biological transmission risk. If you would still rather avoid animal-derived material, synthetic and human donor alternatives exist and we will use them instead.