Oral SurgeryThe Pre-Implant and Adjunctive Procedures That Make Long-Term Success Possible

Under the umbrella of Oral Surgery sit the bone-augmentation procedures (ridge preservation, lateral augmentation, block grafts, sinus lifts), the soft-tissue procedures (free gingival grafts, connective-tissue grafts, vestibuloplasty), the management of impacted or pathological teeth, and the surgical phases of orthognathic and maxillofacial-prosthetic treatment when those overlap with implant rehabilitation.

Precision and our own infrastructure. Your graft is planned on CBCT and a TRIOS 3Shape intraoral scan, and the surgical guide comes from our in-house lab and 3D printer. Grafts use Geistlich Bio-Oss and Bio-Gide. Your written quote names your implant tier: Osstem, Dentium or Zimmer at the Preferred tier, Straumann or Nobel Biocare at the Premium tier.

Written Lifetime Warranty | 25+ super-specialists | Forbes India: No.1 Dental Clinic in India | AAID · AAE · BACD · FDI · ISO 9001:2015 | 10-year open file with milestone reviews | Dr. Priyank Sethi, lead clinician.

For the wider case, see Why India for Dental Treatment and Why Stunning Dentistry. Because grafting and sinus surgery sit directly in the implant pathway, patients comparing destinations often read India vs Bali, India vs Turkey, and Are dental implants abroad safe? before they decide.

1. Pre-Implant Site Preparation

The most common reason. The patient has missing teeth or failing teeth, and the bone or soft tissue at the site cannot accept an implant as it is. Categories include:

• Insufficient ridge width or height. The ridge needs lateral or vertical augmentation before an implant can be placed.
• Insufficient subantral bone. The maxillary sinus has pneumatised down to within 3 to 5 millimetres of the crest. A sinus lift is required.
• Insufficient keratinised gingiva. A free gingival graft or connective-tissue graft is required to ensure long-term peri-implant health.
• Failing teeth that need extraction with ridge preservation. Teeth come out and the socket is grafted to preserve the ridge for delayed implant placement.

2. Same-Visit Adjunctive Surgery

Cases where the surgical and the augmentation phases happen in the same visit. The classic example is socket grafting at the time of extraction, where bone substitute is packed into the socket immediately, with or without a membrane, to preserve ridge dimensions for implant placement four to six months later. Another is the pterygoid implant placement that is sometimes used as an alternative to sinus lift in posterior maxilla cases.

3. Surgical Management of Pathology

Impacted third molars, dentigerous cysts, odontogenic keratocysts, and other pathological lesions of the jaws. Some of these are routine outpatient cases under local anaesthesia. Others require general anaesthesia, which we plan with you before you travel.

4. Orthognathic Overlap Cases

A small number of full-arch cases have a skeletal discrepancy (Class III mandibular prognathism, maxillary hypoplasia or severe asymmetry) that implants cannot correct alone. Those cases need an orthognathic component and are planned with you before you travel. They are documented separately under the Orthognathic Surgery clinical pathway and are out of scope for this hub.

• Ridge preservation grafts. Performed at the time of extraction to preserve socket dimensions for delayed implant placement.- Lateral (horizontal) ridge augmentation. Performed to widen a knife-edge ridge. Membrane-protected particulate, or block grafts harvested from the chin or the ramus, depending on the volume required.
• Vertical ridge augmentation. Performed to add height to a deficient ridge. Higher-complexity, longer healing interval (six to nine months), reserved for cases where short-implant or zygomatic alternatives are not viable.

The full procedure, the biomaterials we use and why, the cases where grafting can be skipped, and the cost in CAD are documented at /treatments/oral-surgery/bone-grafting/.

2. Sinus Lift

Specific to the posterior maxilla. When the maxillary sinus has pneumatised down to within roughly 5 millimetres of the alveolar crest, an implant of normal length cannot be placed without entering the sinus. A sinus lift adds bone substitute to the floor of the sinus, raising the available bone height. There are two approaches:

• Lateral window approach. A bony window is opened on the lateral wall of the maxilla, the sinus membrane is elevated, and bone substitute is packed into the space created.
• Crestal (Summers) approach. A more conservative approach via the implant osteotomy itself. Suitable when 5 to 7 millimetres of crestal bone remain.

The full procedure, the membrane perforation rate, the decision criteria between lateral and crestal, and the threshold at which zygomatic implants beat both approaches are documented at /treatments/oral-surgery/sinus-lift/.

Zygomatic implants, which bypass the sinus floor when upper-jaw bone is too thin, are from $615 per implant, the zygomatic and pterygoid rate. A full zygomatic arch in Canada costs CAD $35,000-$48,000 per arch.

• General anaesthesia is required. Patient preference, surgical extent, or medical comorbidity drives this.
• Multi-quadrant extractions plus full-arch immediate-load placement in one operation. The combined surgical time is long, so the setting is planned in advance.
• Significant medical comorbidity. Patients on anticoagulants who cannot pause therapy, patients with significant cardiac history, patients with bleeding disorders.
• Complex pathology. Cysts requiring marsupialisation, lesions requiring biopsy and frozen-section, cases where overnight observation is appropriate.

Standard healing intervals:

If you need a graft, your treatment is staged: the graft heals first, and your implants are placed on a later trip. The healing time for your procedure is in the table above, and your surgeon confirms it on your CBCT scan before you book flights. We do not place implants into freshly grafted bone unless the simultaneous protocol (crestal sinus lift, simultaneous implant) is clinically appropriate. If you hope for a full arch without a graft on a deeply atrophic ridge, we walk you through the alternative: zygomatic implants, which bypass the maxillary alveolus entirely. That decision is documented on the Zygomatic Implants page.