Are Bone Grafts Necessary If You Want to Get Dentures?

When considering dentures, many people are surprised to hear that bone grafting might come into play. But what does your jawbone have to do with getting a secure, natural-looking smile? The answer isn’t as straightforward as you might think. If you’ve been wondering, are bone grafts necessary if you want to get dentures, the truth may change how you view your treatment options.

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TL;DR

Bone grafts aren’t always required for dentures—it depends on jawbone condition and the type of denture chosen. Conventional removable dentures may work without grafting, while implant-supported dentures often need sufficient structure for stability. A thorough exam, imaging, and medical review help determine the best approach. Alternatives like relines, flexible materials, or minimally invasive implants may reduce the need for grafting. When performed, grafting requires preparation, surgery, and healing but can greatly improve comfort, function, and long-term results.

Are Bone Grafts Necessary If You Want to Get Dentures Are Bone Grafts Necessary If You Want to Get Dentures?

What Are Bone Grafts and Why Might You Need Them for Dentures?

It is a surgical procedure that adds bone—or a similar material—into your jaw to rebuild the bony ridge. In dentistry, this is usually done to restore alveolar bone, the part of the jaw that holds your teeth. Tooth loss, trauma, infection, or even long-term denture wear can cause the bone to shrink, leaving less support for future dentures.

Restoring it helps re-create the height and width of the jaw, giving dentures a more stable and comfortable fit. In some cases, grafting is also essential for implant-retained dentures, since implants need enough bone to anchor securely.

Materials can come from several sources: your own bone (autograft), donated human bone (allograft), animal-derived bone (xenograft), or synthetic substitutes (alloplasts). Each option has its own properties for supporting new bone growth, as well as unique clinical tradeoffs to consider when planning treatment.

Checking for Bone Loss Before Getting Dentures

Before deciding whether a graft is necessary, a detailed evaluation of the jawbone and overall oral health must be completed. During the clinical exam, the dentist checks the ridge shape, measures its height and width, examines the gum tissue, and assesses how existing dentures fit and move. These steps reveal how much bone support remains and whether additional treatment may be required.

Imaging plays a main role in this process. Standard X-rays, such as periapical or panoramic views, provide an initial look at bone height and any pathology. For more precise measurements, cone-beam CT (CBCT) scans are often used. This three-dimensional imaging shows the exact width and volume of the ridge, which is especially valuable when planning grafts or implants.

Medical history is also an important factor. Some medications, like antiresorptive drugs, and conditions such as smoking or uncontrolled diabetes can affect healing and the success of treatment. The amount of bone required depends on the chosen prosthetic plan—whether it’s a conventional denture, a single implant, or multiple implants for an overdenture. Ultimately, the goal is to match the patient’s health and preferences with the available bone and the most suitable treatment approach.

Do You Really Need a Bone Graft for Your Dentures?

The short answer is not always—it depends on the type of denture you choose and the condition of your jaw. In some situations, dentures can be managed without grafting, while in others, bone rebuilding is essential for stability and long-term function.

Main points to consider:

Conventional Removable Dentures: Often managed without grafting through careful design, relines, or soft-tissue procedures. Very narrow or severely resorbed ridges, however, may still cause poor fit and instability.
Implant-Retained or Implant-Supported Dentures: Usually require adequate bone volume for secure implant placement. If it is insufficient, grafting or alternative surgical approaches may be recommended.
Alternative Strategies: Options such as short, narrow, or angled implants can sometimes avoid grafting, though they come with specific limitations.
Risk–Benefit Balance: Grafting adds surgery, cost, and healing time, but it can significantly improve denture stability, facial support, and long-term function. Patient health, preferences, and budget all factor into the final decision.

Other Options If a Bone Graft Isn’t for You

If grafting isn’t the right choice—whether due to personal preference or medical reasons—there are still several ways to improve denture comfort and function. These alternatives range from enhancements to traditional dentures to minimally invasive implant strategies and other specialized approaches.

Improved Removable Prosthetics and Maintenance

Relines and rebasing can re-adapt dentures to a changing ridge.
New impressions and precise bite adjustments may significantly improve stability.
Flexible base materials or alternative denture designs can also help, especially during transitional phases.

Minimally Invasive Implant Strategies

Short or narrow implants: Useful when bone height or width is limited, reducing or avoiding grafting.
Strategic placement: Positioning implants in denser bone areas or at angles may eliminate the need for large grafts. Even a small number of implants for overdentures can enhance comfort and satisfaction in many cases.

Alternative Anchorage and Prosthetic Designs

Mini-implants or locator systems: Provide retention with less bone requirement than conventional implants.
Advanced solutions: In severe cases of upper jaw bone loss, options like zygomatic implants may be considered, though they are more complex and not suitable for everyone.

Non-Surgical Approaches and Counseling

Collaborating with a prosthodontist can help set realistic expectations, provide dietary guidance, and ensure ongoing maintenance.
Open discussions about pros, cons, costs, and care requirements are essential to selecting the most patient-centered solution.

Getting Ready for a Bone Graft and What Comes Next

If a graft is part of your treatment plan, the process begins with preparation. Your dental team will review your medical history, medications, and overall health, sometimes coordinating with your physician if needed. Imaging, such as CBCT scans, helps determine how much bone is required and which graft type and surgical approach are best. You’ll also discuss material options, healing time, potential risks, and the overall treatment timeline before moving forward.

During the procedure, the graft material is placed into the prepared site, often secured with membranes or fixation. If your own bone is used, a second surgical site may be necessary. In some cases, implants can be placed at the same time as the graft, while in others they are added later, after the graft has healed and matured.

Recovery typically takes several months, commonly 3 to 6 or longer, before implants or dentures can be placed. Follow-up visits and imaging confirm healing progress, and post-op care may include medication, a soft-food diet, and careful hygiene. Once the graft is successfully integrated, the next steps depend on your plan: implant placement followed by prosthetic stages, or denture fitting and adjustments if the graft was done solely to improve ridge shape for a conventional denture.

Key Takeaways

Bone grafts and dentures connection: Grafting may be necessary to rebuild jawbone lost from tooth loss, trauma, infection, or long-term denture wear. This helps improve fit, stability, and comfort, especially for implant-supported dentures.
Bone graft materials: Options include your own (autograft), donated human one (allograft), animal-derived (xenograft), or synthetic substitutes (alloplasts), each with unique benefits and tradeoffs.
Assessment before treatment: A thorough evaluation involves clinical exams, imaging (X-rays or CBCT scans), and review of medical history. Factors like medications, health conditions, and prosthetic goals determine whether grafting is needed.
When grafting is required: Conventional removable dentures can often be managed without grafts, but severely resorbed ridges may cause instability. Implant-retained or implant-supported dentures usually require sufficient bone volume, making grafting more common.
Alternatives to grafting: Options include relines or rebasing of existing dentures, flexible materials, minimally invasive implant strategies (short, narrow, or angled implants), mini-implants, locator systems, or advanced solutions like zygomatic implants. Non-surgical approaches and counseling may also improve outcomes.
Risks and benefits: Bone grafting adds surgery, cost, and healing time but can significantly improve denture stability, facial support, and long-term function. Decisions are based on health, preferences, and financial considerations.
What to expect with grafting: Preparation involves medical review, imaging, and treatment planning. During surgery, graft material is placed and sometimes secured with membranes or fixation. Healing usually takes 3–6 months or more, followed by implant placement or denture fitting depending on the treatment plan.

Sources.

Zhao R, Yang R, Cooper PR, Khurshid Z, Shavandi A, Ratnayake J. Bone Grafts and Substitutes in Dentistry: A Review of Current Trends and Developments. Molecules. 2021 May 18;26(10):3007. doi: 10.3390/molecules26103007

Bandiaky ON, Lokossou DL, Soueidan A, Le Bars P, Gueye M, Mbodj EB, Le Guéhennec L. Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications. Clin Exp Dent Res. 2022 Feb;8(1):294-312. doi: 10.1002/cre2.521. Epub 2022 Jan 11. PMID: 35014207; PMCID: PMC8874059.