Implant Bone Graft: When It Is Needed, Materials, Healing Time and Cost
An implant bone graft is an additional surgery that induces bone regeneration when the height or width of the jawbone is too small to place an artificial tooth root. The Korea Disease Control and Prevention Agency (KDCA, 질병관리청) explains that it is usually done before the implant is placed but sometimes at the same time, and that grafting lengthens the healing period. In Korea, bone grafting is not covered even for insured implants for people aged 65 or older, but the implant procedure itself remains covered.
Key facts
| Purpose | Induce regeneration of deficient jawbone to secure a place for the implant (source: KDCA National Health Information Portal) |
|---|---|
| Graft materials | Autograft, allograft, xenograft, synthetic bone (source: KDCA National Health Information Portal) |
| Timing | Usually before placement, sometimes at the same time as placement (source: KDCA National Health Information Portal) |
| Health insurance | Bone grafting for implants is not covered (the implant procedure stays covered) (source: National Health Insurance Service (NHIS, 국민건강보험공단)) |
| Basis of the NHIS decision | Refers to expert opinion that for older patients, a partial denture should be considered first if additional surgery is truly necessary (source: National Health Insurance Service dental implant Q&A) |
Why is an implant bone graft needed?
After a tooth is lost, the jawbone at that site shrinks over time. Even when bone has dissolved because of gum disease, or the bone wall was damaged during extraction, there may not be enough bone to surround the artificial root.
If the implant is placed with too little bone, the fixture may become exposed outside the bone or may not bond sufficiently. So the height and width of the bone are measured with a CT, and the deficient part is filled with graft material to help new bone grow.
The National Health Insurance Service (NHIS) explains that additional surgery is not necessarily required for every implant and is chosen selectively only where truly needed. The extent of the graft varies greatly from person to person.
What materials are used for bone grafts?
The KDCA introduces the person's own bone (autograft), processed bone obtained from another person (allograft), animal-derived bone (xenograft) and artificial synthetic bone as graft materials. Each material differs in how it is obtained and how fast it turns into bone.
Autograft is taken from another part of your own body, so a wound is also made at the harvest site. The other materials need no additional harvesting, but the suitable material differs with the extent and site of the graft. The material is chosen by the dentist based on how much bone is lacking, and the cost also varies by material.
The grafted site is covered with a membrane or the gum is sutured so the graft material does not scatter. The wider the graft, the longer the surgery time, swelling and recovery period, so hearing the extent in advance makes it easier to schedule.
When is a bone graft done, and how much longer does it make treatment?
If a lot of bone is lacking, the graft is done first and the implant is placed after the bone has settled. If the deficiency is small, the empty space around is sometimes filled at the same time as the fixture is placed.
An implant generally takes 3-4 months to bond with the bone, and with a bone graft, the time for the graft site to heal is added on top. The exact period differs with the extent, material and site of the graft, so check the schedule for each stage when the treatment plan is made.
If the bone below the maxillary sinus is low in the upper back teeth area, bone height is secured by a separate method called sinus lift. In this case too, the time for the grafted bone to settle is added to the overall implant schedule.
Does health insurance in Korea cover implant bone grafts?
It does not. The rules on medical care benefit criteria in Korea set additional surgery for dental implants, including bone grafting, as non-covered. Even for an insured implant for people aged 65 or older, the bone graft cost is paid entirely by the patient.
However, having a bone graft does not cancel implant insurance. Only the additional surgery is handled as non-covered, and diagnosis, fixture placement and prosthesis restoration proceed with the 30% copay. The NHIS says it set this standard by referring to expert opinion that for older patients, a partial denture should be considered first if additional surgery is truly necessary.
- Not covered: additional surgery for implants such as bone grafting and sinus lift
- Stays covered: the diagnosis and treatment planning, fixture placement and prosthesis restoration stages
- Calculated separately: extraction at the implant site
What should I watch out for after a bone graft?
The graft site may be swollen and sore for the first few days. Do not chew on that side so the wound does not open, and take the prescribed medication as directed.
Smoking interferes with both bone regeneration and implant bonding, so it is better to quit before and after the graft. If you have diabetes, blood sugar control affects wound healing. If pus comes from the graft site or granules of graft material keep coming out, get it checked at the dental clinic.
- Do not chew on the grafted side and eat soft foods
- Do not touch the wound with your tongue or hands until the stitches are removed
- Avoid smoking and alcohol
- Contact the clinic right away if swelling keeps growing or you get a fever
Common myths and facts
Myth: Everyone needs a bone graft to get an implant.
The National Health Insurance Service explains that additional surgery is chosen selectively only when truly necessary. If there is enough bone, the implant is placed without a graft.
Myth: If you have a bone graft, the whole insured implant becomes non-covered.
Only the bone graft cost is non-covered, and the implant procedure remains covered.
Frequently asked questions
When can I know whether a bone graft is needed?
It is decided after checking the height and width of the jawbone and the distance to the nerve canal and maxillary sinus with a dental CT. The extent is sometimes adjusted after seeing the bone directly during surgery, so ask about the possibility in advance at the consultation.
How is the bone graft material chosen?
The dentist recommends it based on how much and where the bone is lacking and whether autograft can be harvested. Get an explanation of each material's characteristics and why that material is used for you, and if you are uncomfortable with animal-derived material or harvesting your own bone, say so in advance at the planning stage.
Does an implant last longer if I have a bone graft?
A graft is a process that fills the lacking bone so the implant can be placed. For long-term use, oral hygiene, not smoking and regular check-ups matter more than whether a graft was done. A grafted site can also lose bone again if peri-implantitis develops, so the care method is the same.
How is the cost of a bone graft decided?
Because it is not covered, it differs from clinic to clinic and varies with the extent of the graft, the material and whether a barrier membrane is used. It is easier to compare if you receive the items separately from the implant quote. If the extent may grow during surgery, also check beforehand the standard for additional cost at that time.
If there is too little bone, can I not get an implant?
Whether it falls within what a graft can make up for, or whether dentures or a bridge are better, is decided by looking at general health and bone condition together. The KDCA also introduces dentures as an alternative when gum bone resorption is severe and an implant is difficult. Compare the duration and cost of the options side by side before deciding.