Bone Grafting & Sinus Lift · Led by Dr. Hung Le Ba Gia (Dr. Evans) · Last reviewed May 2026
Rebuilding Bone, Rebuilding Possibilities.
Picasso Dental performs dental bone grafting and sinus augmentation in Vietnam, using Bio-Oss xenograft, autograft, allograft and synthetic materials with Bio-Gide collagen membranes, planned by CBCT 3D imaging. Reliable, predictable, internationally documented protocols that turn deficient jaw bone into a foundation strong enough to hold an implant for decades.
What is Dental Bone Grafting?
Dental bone grafting is a surgical procedure that rebuilds jaw bone where it has shrunk or been lost. After a tooth is missing for an extended period, the jaw bone in that area resorbs (shrinks), often leaving inadequate bone to support an implant. Graft material is placed at the deficient site under a collagen membrane and allowed to integrate over 6 months, regenerating the volume needed for a successful implant.
Why Bone Grafting Matters
Bone Resorbs Without Teeth
The jaw bone is preserved by the chewing forces transmitted through tooth roots. Once a tooth is lost, those forces stop, and the bone in that area gradually shrinks. After 5+ years, the loss can be substantial.
Implants Need Bone
A dental implant needs adequate bone height and width to be placed safely. If your CBCT shows insufficient bone, a graft rebuilds the foundation before the implant goes in.
The Honest Alternative: A Bridge
If you do not want a graft, a tooth-supported bridge or denture remains an option. Both have trade-offs (grinding healthy teeth, slipping). Grafting expands the implant pathway, it doesn't force it on you.
Types of Bone Graft Procedures
The right procedure depends on the size of the defect, where it is, and whether the implant can be placed at the same time.
GBR (Guided Bone Regeneration)
When: Moderate horizontal or vertical bone deficiency. The standard procedure for most implant grafts.
What's involved: Bio-Oss particulate graft + Bio-Gide collagen membrane. Often combined with simultaneous implant placement.
Healing: 6 months.
Socket Preservation
When: At the time of tooth extraction, to preserve the socket for future implant placement.
What's involved: Graft material placed into the empty socket immediately after extraction. Membrane covers the site.
Healing: 4 months before implant.
Closed Sinus Lift (Transcrestal)
When: Mild to moderate sinus pneumatisation in the upper back jaw, needing 4 mm of additional bone height.
What's involved: The sinus floor is lifted gently through the implant socket itself, graft material placed, often combined with simultaneous implant placement.
Healing: Standard implant timeline ( 4 months).
Open Sinus Lift (Lateral Window)
When: Substantial sinus pneumatisation needing more than 4 mm of additional bone.
What's involved: A small bony window is opened on the side of the jaw, the sinus membrane elevated, and Bio-Oss + Bio-Gide placed. Larger and more involved than a closed lift.
Healing: 9 months before implant.
Block Graft
When: Severe vertical or horizontal bone loss. A solid piece of bone (rather than particulate graft) is needed.
What's involved: Bone block harvested from your own jaw (chin, ramus) or processed allograft block, secured to the deficient site with screws.
Healing: 6 months before implant.
Autograft (Your Own Bone)
When: Biological compatibility is the priority, or in combination with other graft materials.
What's involved: Bone harvested from your own jaw and placed at the deficient site. Sometimes mixed with Bio-Oss to extend volume.
Healing: 6 months.
Graft Material Options
Four classes of graft material exist, each with different properties. We match the material to your specific case.
| Material | Source | How It Works | Best For |
|---|---|---|---|
| Xenograft (Bio-Oss) | Deproteinised bovine bone | Scaffold, your own bone grows in and replaces it | Default choice · Most extensively documented |
| Autograft | Your own bone (jaw or hip) | Living bone cells, fastest regeneration | Complex cases · biological priority |
| Allograft | Processed human donor bone | Scaffold, processed and sterilised | Block grafts · alternative when Bio-Oss not preferred |
| Alloplast (Synthetic) | Laboratory-made calcium phosphate | Scaffold, gradually replaced by bone | Patients preferring non-animal materials |
| Bio-Gide Membrane | Porcine collagen | Barrier that keeps soft tissue out of the graft site | Used with most graft materials |
Bio-Oss is our default choice for most cases, 30+ years of clinical documentation. We discuss alternatives if you have material preferences.
The Procedure, Step by Step
Standard timeline for a GBR or sinus lift graft, from CBCT to implant placement.
CBCT 3D Scan
Cone Beam CT scan maps the deficient site in three dimensions, height, width and proximity to anatomy.
Day 1 · 15 minSurgical Planning
Graft type, material and approach decided. Combined-with-implant or staged plan agreed.
Day 1–2Graft Surgery
Local anaesthetic. Graft material placed at the deficient site under a Bio-Gide membrane. Sutures placed.
Surgery · 45–90 minHealing Period
9 months depending on graft type. Soft food in the first week, gradual return to normal eating.
4–9 monthsFollow-up CBCT + Implant
Repeat CBCT confirms bone regeneration. Implant placed at the now-grafted site.
Implant visitSinus Lift Deep-Dive
Sinus lifts are the most commonly requested grafting procedure for the upper back jaw, and one of the most asked-about procedures by patients planning implants.
Closed Sinus Lift (Transcrestal)
When it works: When 6 mm of bone height already exists below the sinus floor and you need 4 mm more.
How it works: The implant socket is prepared up to but not through the sinus membrane. Graft material is gently pushed up, raising the sinus floor. Implant placed in the same visit.
Recovery: Comparable to a normal implant. Mild swelling, no nasal bleeding in most cases.
Cost:.
Open Sinus Lift (Lateral Window)
When it works: When less than 5 mm of bone height exists below the sinus, and substantial augmentation (5+ mm) is needed.
How it works: A small bony window is opened on the side of the jaw, the sinus membrane carefully elevated, and Bio-Oss with Bio-Gide placed beneath. Implant placed simultaneously if stability allows, otherwise after 9 months.
Recovery: 5 days of swelling, no nose-blowing for 4 weeks, saline rinses recommended.
Cost:.
Combined vs Staged: When We Place Implants Same Visit
Smaller grafts can be combined with implant placement in the same surgery. Larger grafts require staged treatment.
Combined (Single Surgery)
Indications: Small contour grafts at extraction sites, minor GBR around an implant, transcrestal sinus lift with simultaneous implant.
Advantages: One surgery, one healing period, faster total treatment.
Trade-off: Slightly higher technique demand. Not all defects qualify.
Staged (Two Surgeries)
Indications: Block grafts, open lateral-window sinus lifts, severe atrophy needing substantial vertical regeneration.
Advantages: Predictable healing, the bone is fully regenerated before the implant goes in.
Trade-off: Two surgeries, longer total timeline (typically +6 months).
How We Decide
The CBCT scan tells us. Defect size, bone quality, and the implant trajectory determine whether combined or staged is the right approach. We are conservative, when in doubt, we stage to maximise predictability.
Same-Day Extraction + Graft + Implant
The most common combined scenario. A failing tooth is extracted, the socket is grafted and contoured, and an implant is placed in the same visit. Healing happens for everything simultaneously over 4 months.
When We Avoid Combined
Active infection at the site, very large defects, severely compromised bone quality. In these cases, treating one variable at a time produces better outcomes.
The Honest Conversation
Some clinics push combined surgery as a marketing point. We do not, the timeline matters less than the predictability. We tell you which approach fits your case.
Recent Bone Graft Cases
A small selection of recent grafting cases. Every photograph shows an actual Picasso Dental patient, published with their written consent.
GBR + Single Implant
Lower Premolar · Bio-Oss + Osstem
Patient from Hanoi · Treatment: 8 months · Hanoi Old Quarter
Open Sinus Lift
Upper Right Posterior · Lateral Window + Bio-Oss
Patient from Sydney · Treatment: 12 months · Da Nang Vinmec
Socket Preservation Graft
Front Incisor · Bio-Oss
Patient from London · Treatment: 4 months to implant · HCMC Thao Dien
Block Graft
Ramus Autograft to Lower Posterior
Patient from Auckland · Treatment: 10 months · Da Nang Vinmec
Bilateral Sinus Lift + All-on-6
Upper Arch · Bio-Oss + Bio-Gide × 2
Patient from Singapore · Treatment: 14 months · Da Nang Vinmec
Combined Extraction + Graft + Implant
Upper Premolar · Bio-Oss + BLX
Patient from Da Nang · Treatment: 4 months · Da Nang Hoà ng Diệu
Who Will Perform Your Bone Graft
Bone grafting at Picasso Dental is led by Dr. Hung Le Ba Gia (Dr. Evans), with extensive experience in GBR, sinus augmentation, block grafts and adjunct procedures supporting implant placement.
Lead Implant Specialist
Dr. Hung Le Ba Gia (Dr. Evans)
Picasso's dedicated implant specialist. Bone grafting and sinus augmentation are core to his daily practice, the foundation that makes complex implant cases possible.
Founding Clinical Director
Dr. Emily Nguyen
Founder of the original clinic in 2013. Sets clinical standards for graft case selection, surgical protocols and material choices group-wide.
Clinical Co-leader
Dr. Ben Pham
Founding clinical leadership member. Senior role across all six branches. Co-establishes implant and grafting quality benchmarks and audit protocols.
Caring for Your Graft Site
The first 4 weeks after grafting are the most important. Strict adherence to post-op instructions makes the difference between predictable healing and graft failure.
First 7 Days
Soft food only. No smoking, no straws, no vigorous rinsing. Saline mouthwash from day 2. Antibiotics and pain relief as prescribed. Cold compress on the cheek for the first day reduces swelling.
Sinus Lift Specific
No nose-blowing for 4 weeks. Sneeze with mouth open. Avoid air travel for 2 weeks. Saline nasal spray helps. Avoid pressure changes (scuba diving, freediving) until healed.
Days 14
Suture removal (or dissolvable sutures fall away). Diet returns to normal-soft. Begin gentle brushing of the graft area with a soft toothbrush.
Weeks 16
Normal eating returns. The graft is integrating beneath the gum, no visible activity but biological work is happening continuously. Follow-up X-rays at 3 months confirm progress.
Months 6
Final CBCT confirms bone regeneration. Implant placement scheduled.
What to Avoid
Smoking is the single biggest threat to graft success. Vigorous rinsing in the first week can dislodge the graft. Trauma to the site (chewing on it, brushing aggressively) can compromise healing.
The International Bone Graft Journey
Two paths for international patients needing grafting before implant placement. Choose the one that fits your time and your budget.
Option A: Two Trips (Standard)
Trip 1 ( 7 days): Consultation, CBCT, graft surgery (and any extractions). Recovery in Vietnam, fly home.
Wait at home: 9 months for graft to integrate. WhatsApp check-ins.
Trip 2 ( 7 days for implant; further trips for crown): Follow-up CBCT, implant placement, then later returns for the crown.
Best for: Most patients · Bone healing time at home · Travel split across multiple trips.
Option B: Single Extended Trip
One trip ( 12 months): Consultation, CBCT, graft, healing, implant, healing, crown, all in one stay.
Best for: Retirees · Remote workers · Patients who can take an extended period in Vietnam.
Bonus: Continuous care under the same team · Low cost of living during healing.
Risks & Success Rates: Honestly
Bone grafting is highly predictable in trained hands but not without risk. Here is what the literature reports and how Picasso minimises every avoidable risk.
Documented Success Rate
Long-term clinical literature consistently reports GBR success rates above 90 percent and sinus augmentation success above 95 percent. Bio-Oss specifically has 30+ years of documented clinical use with implant survival comparable to native bone sites.
What Can Go Wrong
Graft failure (graft does not integrate, requires re-graft). Membrane exposure (the Bio-Gide membrane becomes exposed through the gum). Sinus membrane perforation during a sinus lift (managed intra-operatively). Sinusitis after a sinus lift (typically responds to antibiotics).
How We Minimise Risk
CBCT 3D imaging before every graft. Autoclave sterilisation. Genuine Bio-Oss and Bio-Gide products only (verifiable batch numbers). Strict surgical protocol. Patient education on aftercare.
If the Graft Fails
If a graft fails to integrate within the planned healing window, we re-graft at no additional cost. Re-graft success rates are similar to first-attempt rates. The implant pathway is not compromised.
Smoking & Bone Grafting
Smoking is the single biggest threat to graft success. Smoking constricts blood vessels and compromises the healing required for graft integration. We strongly recommend stopping at least 2 weeks before surgery and 8 weeks after, ideally permanently.
When We Decline
Active infection at the site (must be resolved first), severely uncontrolled diabetes, recent IV bisphosphonate therapy, recent radiation to the jaw. We tell you honestly when grafting is not the right choice.
Frequently Asked Questions
What is dental bone grafting?
Dental bone grafting is a surgical procedure that rebuilds jaw bone where it has shrunk or been lost. Graft material is placed at the deficient site under a collagen membrane and allowed to integrate over 6 months, regenerating the bone volume needed to support a dental implant.
How much does dental bone grafting cost in Vietnam?
At Picasso Dental, GBR bone grafting starts at, autograft, closed sinus lift, block graft, and open sinus lift. Graft costs are added to the implant procedure cost, not bundled into it.
Why would I need a bone graft?
After a tooth is lost, the jaw bone in that area shrinks over time, particularly in the first year. If you have been missing teeth for years and want to replace them with implants, the available bone may be inadequate to hold the fixture securely. Bone grafting rebuilds the volume needed for a successful implant.
What is a sinus lift?
A sinus lift (also called sinus augmentation) is a specific type of bone graft for the upper back jaw. The maxillary sinus is gently elevated and bone graft material placed beneath it, creating sufficient bone height to support upper-back-jaw implants. There are two techniques: closed (transcrestal) and open (lateral window).
What is Bio-Oss?
Bio-Oss is a deproteinised bovine bone xenograft, the most extensively documented bone graft material in dentistry. It serves as a scaffold that your own bone grows into and replaces over time. We use Bio-Oss with Bio-Gide collagen membrane as our default GBR grafting protocol.
How long does bone graft healing take?
GBR bone grafting typically takes 6 months to integrate before an implant can be placed. Sinus lifts (especially open lateral window) typically need 9 months. Block grafts can need 6 months. Some smaller grafts can be combined with simultaneous implant placement.
Is bone grafting painful?
The surgery is performed under local anaesthetic, sometimes with sedation for larger grafts or sinus lifts. Most patients describe the post-operative experience as comparable to a tooth extraction: mild swelling for 5 days, managed with prescribed pain relief. Block grafts and open sinus lifts have slightly more discomfort during initial healing.
Will I always need a graft for an implant?
No. Many patients have adequate bone for direct implant placement, particularly if the tooth has been missing for less than a year. CBCT scanning on day one tells us definitively. Some protocols (notably All-on-4) are specifically designed to avoid grafting by using available bone.
Where does the graft material come from?
Four sources. Xenograft (bovine, the most common, e.g. Bio-Oss). Autograft (your own bone, harvested from a different jaw site). Allograft (processed human donor bone). Synthetic/alloplast (laboratory-made calcium-based material). We choose based on the size and complexity of the defect.
Are bovine xenografts safe?
Yes. Bio-Oss is a deproteinised mineral scaffold, all biological proteins are removed during processing. There has never been a documented case of disease transmission with Bio-Oss in 30+ years of global use. It is approved for medical use by the FDA, CE and equivalent regulators worldwide.
What is a block graft?
A block graft uses a solid piece of bone (rather than particulate graft material) to rebuild substantial vertical or horizontal defects. The block can be your own bone (harvested from the chin, ramus or hip) or a processed allograft block. Block grafts are reserved for severe defects and have longer healing times.
Can I have a graft and an implant in the same visit?
Sometimes. Smaller GBR grafts and contour grafts at extraction sites are commonly combined with simultaneous implant placement. Larger grafts (block grafts, open sinus lifts) typically require staged treatment, graft first, implant placed 9 months later. CBCT and the size of the defect tell us which is appropriate.
Related Treatments
Single Tooth Implant
Many single tooth implants need a small GBR graft at placement, particularly when the tooth has been missing for years.
All-on-4 Full Arch
The All-on-4 protocol was specifically designed to avoid grafting in many full-arch cases by angling the rear implants to use available bone.
Zygomatic Implants
For severe upper jaw bone loss, zygomatic implants offer an alternative that avoids extensive grafting altogether.
Start Here
Find Out If You Need a Graft
Within 24 Hours.
Send us your CBCT scan if you have one, or book a consultation for a free CBCT review. Our implant team tells you honestly whether grafting is needed, what type, the timeline, and the all-in cost including the eventual implant.