Molar Extraction: Do I Need a Bone Graft if I Don't Plan to Get a Dental Implant?


Pam asks:

I am having a molar extracted. The very last tooth on the top. I am being told to have a bone graft as well to preserve the ridge. The bone graft is quite expensive. I really doubt that I will ever be getting a dental implant. So is the bone graft something that I really need to have done? What are the risks if I don't get the bone graft?

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Expert Advice and Comments
Mitchel S. Godat DDS, MS's picture

Molar Bone Grafting

The first question is do you need to replace this tooth. The answer maybe. Do you have a lower tooth that bites with the tooth being removed? If so, then I would consider replacing your tooth. Additionally which molar are we referring. The first molar offers the highest chewing function in the mouth and is therefore very important to replace. The second molar offers less function. With my patients, I find about 60 to 70% miss having the second molar tooth.

The next question is why graft? In my experience, the bone on the upper jaw has a great tendency to shrink. Additionally the bone on the upper jaw is not as strong and a bone graft makes this bone harder. This makes it easier to place an implant. Most of the time when I a tooth needs an extraction, I also discuss with the patient about the possible need for the bone graft.

Not grafting now, may result in a great expense later. It usually is less expensive, less painful, and easier to place the graft the day the tooth is removed. In my opinion the grafting gives you the best option for the implant later.

As long as the above are answered by your surgeon then I would proceed with the graft.

cboudet's picture

Do I Need a Bone Graft if I Don't Plan To Get an Implant?

Answered By: Dr. Carlos Boudet - West Palm Beach , FL

Dear Pam:
If the tooth is the very last molar on top and you don't plan to get an implant, or don't anticipate loosing all your upper teeth and needing a denture, I would say no, you don't need a bone graft.
The only risk of not getting a bone graft is loosing bone in that area and having the opposing molar supraerupt (grow), affecting the bite, then not having enough bone to place an implant without sinus grafting.
Ultimately only you can decide what you want to do.
Good luck!

Carlos A. Boudet, DDS, DICOI

drkazemi's picture

To bone graft or not?

Answered By: Dr. H. Ryan Kazemi - Bethesda , MD


Bone graft (also known as extraction site preservation bone graft) helps to preserve the bone and prevent bone loss and shrinkage over time. If you are not considering implant, then it may not be as crucial to have the bone graft done. However, many of my patients have changed their mind later and wanted implant replacement and it is always good to know that there is sufficient bone available to do that and avoid more costly and more invasive bone grafting procedures later.

Dr. H. Ryan Kazemi

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