When a bone graft or sinus lift changes the plan
Many All-on-6 cases need no grafting at all. Some do, and when the 3D scan shows too little bone, the timetable of the two trips can change. Here is how and why, and how to plan so it does not catch you out.
Medically reviewed by Dt. Hüseyin Yavuz Özbek, implant surgeon · Updated October 2026If the CBCT scan shows the bone is too thin or too low in places, the surgeon may add bone (a graft) or lift the floor of the sinus in the upper jaw. Small grafts are often done at the same time as the implants and add little time. Larger grafts or sinus lifts can need several extra months to mature, may mean fixed teeth are delayed, and occasionally add a trip. Ask before you book whether your X-ray suggests grafting and how it would affect the trips.
Of all the things that can change a carefully planned All-on-6 trip, bone is the most common. You can do everything right: send an X-ray, get a written plan, book flexible flights. Then the 3D scan on the first morning shows that the bone in the upper back jaw is lower than the X-ray suggested, or that the lower ridge is thinner at the front. The plan has to adapt. Knowing how in advance keeps it from feeling like a surprise.
Why bone is sometimes missing
Bone in the jaw is there to support teeth. When teeth are lost, or have been loose for years from gum disease, the bone around them shrinks. In the upper jaw, the maxillary sinuses can also expand downwards over time after back teeth are lost, leaving less height for implants. People who have worn dentures for many years, or had advanced gum disease, are more likely to have reduced bone. See from dentures to fixed teeth.
Why the X-ray is not enough
A panoramic X-ray is a flat image. It shows the height of the bone reasonably well and gives a good overview of the teeth, but it cannot show the width of the bone or its exact relationship to the sinuses and nerves in three dimensions. That is what the CBCT scan on the first appointment is for. It is why a responsible provisional plan says that grafting may or may not be needed, and that the final plan follows the scan.
The main types of graft
| Procedure | What it does | Typical effect on the trips |
|---|---|---|
| Small graft at the same time as the implants | Fills a gap or covers a thin area around an implant | Usually none; may slightly extend healing |
| Socket preservation after extraction | Fills extraction sockets to reduce shrinkage | Usually none in a full-arch case |
| Sinus lift with implants placed at the same time | Adds height under the sinus where some bone remains | Longer healing before the final bridge |
| Sinus lift or block graft first, implants later | Builds up bone where very little remains | Several months before implants; often an extra trip |
The Oral Health Foundation notes that if bone needs to be built up, treatment takes longer. How much longer depends on the procedure and on you.
Avoiding a graft where possible
Part of the appeal of full-arch concepts is that they can sometimes avoid grafting. By tilting the back implants to use the stronger bone further forward, or by adjusting implant positions along the arch, a surgeon can often work with the bone you have. Whether that suits your mouth depends on the scan. If you are offered a graft, it is reasonable to ask whether an alternative implant layout would avoid it, and why it would or would not be suitable for you.
How grafting changes the timetable
When a graft or sinus lift is done at the same time as the implants, the main effects are:
- Longer healing before the final teeth. The second trip may move from around four months to six or more for that jaw.
- Fixed temporary teeth may be delayed. Grafted areas are less able to take load immediately. See when same-day teeth are not possible.
- More swelling and bruising. Especially after a sinus lift, for the first week.
- Specific flying advice. After a sinus lift, surgeons often give instructions about nose-blowing and pressure changes. Ask before booking your return flight.
When grafting must come first and implants later, the journey usually gains a stage: a first trip for the graft, healing at home, a trip for the implants and temporary teeth, more healing and a final trip for the finished bridge.
Sinus lifts and the flight home
A sinus lift involves the membrane lining the sinus. In the days afterwards, surgeons commonly advise against blowing your nose hard, sneezing with your mouth closed, using straws and, in some cases, flying until they are happy with healing. Advice varies by technique and surgeon. If a sinus lift is likely, ask how it affects the earliest safe date to fly, and keep the return flexible. Our article on booking flights for both trips explains how.
Where grafting material comes from
Bone grafts use one of several materials: your own bone, taken from nearby in the jaw; processed bone from a donor; bone-like material from animal sources; or synthetic substitutes. Each has advantages, and surgeons choose based on the size of the defect and their experience. If the origin of the material matters to you for personal, religious or dietary reasons, say so before treatment and ask what will be used. It should be written into your plan alongside the implant brand.
What a graft feels like afterwards
A small graft placed with the implants is rarely noticed separately from the general soreness of surgery. A sinus lift or a larger graft can bring more swelling, bruising that spreads to the cheek or under the eye, and sometimes a feeling of pressure in the sinus or a slightly blocked nose on that side. These usually settle over a week or two. Pain that increases after the third day, a foul taste, fever or discharge from the nose should be reported to the clinic straight away, because they can signal infection.
Planning for the possibility
- Ask whether your X-ray suggests a graft or sinus lift might be needed.
- Ask how each possibility would change the number of trips and the time between them.
- Ask for the price of each likely procedure in writing, and how it is charged (per side, per area, per amount of material).
- Book a flexible return flight on trip one.
- Tell your employer the second trip date is provisional.
Healing well after a graft
Grafted bone needs a good blood supply and a quiet environment to mature. The things that most help are the same ones that help implants: not smoking, keeping diabetes under control, taking antibiotics exactly as prescribed, not disturbing the area with your tongue or fingers, and keeping to soft food for as long as advised. Smoking is particularly damaging to grafts. See stopping smoking before All-on-6.
Cost and fairness
Because grafting decisions follow the scan, the final price can differ from the provisional one. A fair clinic explains this before you travel, gives a written price for the procedures most likely to be needed, and confirms the final price after the scan before any treatment starts, so you can decide with the full picture. If you are told on the day that a graft is needed, you should still be given the reason, the alternatives and the cost, in writing, before you consent.
At Precious Dental the CBCT scan on the first visit decides whether a graft or sinus lift is needed. Our published prices list sinus lifts per procedure and bone graft per 1cc, and any addition is confirmed in your written plan before surgery.
The short version
Most All-on-6 patients do not need major grafting. If you might, the scan will show it, the timetable will usually stretch rather than collapse, and a flexible approach to flights and dates turns a potential shock into a manageable change. Read how long between the two trips for how healing sets the date of the second visit.
Common questions
Will I find out before the trip whether I need a graft?
A panoramic X-ray can suggest it, but only a 3D CBCT scan shows the width and height of the bone reliably. Many final decisions are made after the scan on the first trip.
Does a bone graft mean an extra trip to Turkey?
Not always. Small grafts placed with the implants usually do not change the number of trips. Larger grafts or sinus lifts sometimes do, because the graft needs time to mature before implants or final teeth.
Can All-on-6 avoid a graft?
Sometimes. Angling the back implants or adjusting their positions can use the available bone and avoid grafting in some cases. Whether that is possible depends on your anatomy.
What is a sinus lift?
A procedure in the upper back jaw that raises the floor of the sinus and adds bone beneath it, so there is enough height for an implant.
Will a graft change the price?
Often, yes. Grafts and sinus lifts are usually priced separately. Ask for the likely cost in writing before you travel, and make sure the final plan after the scan confirms it.
Sources
- Oral Health Foundation: dental implants (bone grafts and healing)
- British Society of Periodontology: patient FAQs about dental implants
- Cochrane: different times for loading dental implants (Esposito et al., 2013)
- NHS: treatment abroad checklist
Checked October 2026. Where we give our own view as a clinic, we say so.
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