Why the bone comes first
An implant is anchored directly in the jawbone, which needs enough volume and density to hold it. Once a tooth is lost, the surrounding bone is no longer stimulated by chewing and starts to resorb, losing height and width. It begins within months and continues for years.
Rebuilding what was lost
Graft material is placed where bone is missing and acts as a scaffold. Over the following months, the patient's own bone grows into it and replaces it. In the upper back jaw, where the sinus sits close to the ridge, a sinus lift may be needed to create the vertical space an implant requires.
One stage or two
Where the deficit is limited, graft and implant can be placed in the same surgery. Where more rebuilding is needed, the graft heals first. The choice is made on a 3D scan. Grafting adds time: what it buys is an implant set in adequate bone rather than compromised bone.
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