Implants need bone. Planning protects it.

Why bone disappears after a tooth does

The bone that holds a tooth exists because the tooth is there — chewing forces travel down the root and tell the bone it has a job. Remove the tooth and the signal stops. The ridge narrows and shrinks, fastest in the first months, slowly for years afterward. Infection, gum disease, and traumatic extractions accelerate the loss.

None of this hurts, and none of it is visible day to day, which is why it surprises patients years later: the space where a molar came out in 2019 may no longer hold an implant in 2026 without rebuilding first. The biology is ordinary. The planning question is whether anyone got ahead of it.

Socket preservation: the graft that prevents grafts

The cheapest, simplest graft is the one placed the day the tooth comes out.

When a tooth is extracted at MSD and there's any realistic chance the space will one day hold an implant, we talk about socket preservation before the extraction, not after: a bone graft material placed gently into the socket at the same visit, protecting the ridge while it heals. It adds a few minutes to the appointment and little to the recovery — most patients can't tell where the extraction ends and the graft begins.

What it buys is options. A preserved socket typically heals into a ridge that accepts an implant without further surgery. An unpreserved one may too — or may need a larger graft, more healing time, and more cost, months or years later. Whether a specific tooth warrants it depends on the site, your plans, and honest odds you'll ever want the implant; a lower wisdom tooth usually doesn't, a first molar usually does. We'll tell you which yours is.

When more than a socket graft is needed

Sites that lost bone long ago, or lost it to disease, sometimes need rebuilding before an implant is possible:

• Ridge augmentation — rebuilding width or height where the ridge has narrowed, so an implant can sit in bone rather than against it.
• Sinus-area grafting — in the upper back jaw, the sinus sits close above the ridge; when the bone between is too shallow, it's built up before or during implant placement.
• Grafting around gum-disease damage — bone lost to periodontitis is addressed only after the disease itself is controlled; grafting into active infection fails. See our guide on gum disease and when a specialist is needed.

Straightforward grafting is done here. Where a case genuinely calls for specialist surgical care — extensive augmentation, complex sinus work — we say so and refer, and we coordinate the implant restoration when you return. That honesty is cheaper for you than optimism.

The scan decides, not the sales script

Every grafting and implant decision at MSD starts with a CBCT 3D scan: exact bone height, width, and density, the position of the nerve and sinus, and the quality of the site — measured, not estimated. Sometimes the scan shows ample bone and shorter timelines than the patient feared. Sometimes it shows a site that needs building. Either way you see the scan yourself, and the plan follows the anatomy. How that planning works from the final tooth backward is covered in how dental implants are really planned — and if you're weighing whether to save the tooth instead of extracting at all, start with save the tooth or replace it, because the best site preservation is sometimes keeping the tooth.

Healing timelines, honestly

A preserved socket typically matures three to six months before implant placement; larger grafts take longer. The timeline is verified rather than assumed — a follow-up scan confirms the bone is ready before the implant is scheduled. Rushing this step is how implants inherit weak foundations, and it's the step where "fast" marketing and durable dentistry part ways. Phasing also spreads cost: extraction and preservation now, implant when the site — and your budget — are ready. What each stage costs is laid out plainly in why implant quotes differ by thousands.

Who does this work

Grafting and implant planning at MSD are handled by Dr. Matthew Dillon — a general dentist with advanced continuing education in implant and surgical dentistry, including a Fellowship with the International Congress of Oral Implantologists (FICOI) and Kois Center training — working jointly with Dr. Shantall Di Loreto on the restorative plan every graft ultimately serves. We're a private, doctor-owned practice on N University Drive in Coral Springs, seeing patients from Parkland, Coconut Creek, Tamarac, Margate, and across North Broward.