Implants need to be placed in firm bone, when there is not enough bone available it may be possible to build up the bone using a bone graft. Often this is taken from the chin, but can be from the jaw (at the back) or sometimes elsewhere. The choice of bone is actually quite important (the hip bone can be used, but this bone does not do particularly well with implants and requires a general anaesthetic). The bone is collected from the jaw, and placed where needed at the same visit. It is advisable to have sedation for this appointment though only a local anaesthetic is needed. The procedure is carried out under aseptic conditions, this means that the surgeon and nurse will be wearing sterile gowns, masks and hats to minimise the chances of any infection. You too will also be covered with a drape which covers the shoulders and torso. You will have a cap, and glasses. The jaw will be sore for a few days, and there will be some swelling and bruising, however the bone is excellent for implants and they have a good success rate. Please bear in mind that the success rate is lower than placing implants into adequate natural bone, for example without a bone graft. I would suggest that a few days off be reasonable. As with any minor surgical procedure you are likely to get a little bleeding and pain, certainly some swelling, and bruising. A chin graft will need a 24hour bandage. In the lower jaw there are important nerves which supply sensation to your lower lip and chin. It is possible that the surgery will leave you with a temporary disruption of this nerve. This means that you may have less sensation, more sensation (or painful sensation) or no sensation. Everything will be done to minimise this risk, but you must be aware that the risk is unavoidable. In rare cases, none in my care, it is possible that the sensation alteration is permanent.
At a later stage dental Implants are placed into the regenerated jaw bone, usually some 4 months following the graft procedure. This requires a minor surgical procedure with the same protocol as for the graft procedure; you may wish to have sedation again. You will be numbed up in the mouth - very much like having a tooth out. You need to be aware that implant placement can only be carried out if the bone graft has successfully generated sufficient bone. After implant placement surgery I would expect you to have a little discomfort for a few days. This will vary dependent upon the procedure and your own healing. In most cases I would recommend that you take ibuprofen after the procedure. In all cases it is imperative that you follow the instructions you will be given. This will usually be to avoid any mouth rinsing for 24 hours followed by gentle rinsing with hot salt water for a week. This healing period is crucial, I do expect you to be able to eat well and function, but wish to avoid any direct force on the implant site(s).