How do we know one is needed
A 3D scan (CBCT) measures available bone height and width to the tenth of a millimeter. The critical threshold is around 8 mm in the upper jaw and 10 mm in the lower. Below that, a graft is proposed.
Autogenous, allogeneic or synthetic graft
Three options: harvest from your own mouth (chin, ramus), irradiated human bank bone (allogeneic), or synthetic substitutes (bioceramics). In Tunisia, synthetics and allogeneics cover 90% of cases — no second surgical site.
Sinus lift: raising the sinus
At the upper posterior jaw, the maxillary sinus often drops when a molar is lost. Sinus lift gently detaches the sinus membrane and slips a bone substitute underneath. Well-codified, nearly painless, 20-30 minutes.
How long before the implant?
Small graft (socket filling after extraction): 3-4 months. Standard sinus lift: 4-6 months. Major reconstruction: 6-9 months. This is why a full implant plan sometimes requires two trips several months apart.
Real cost in Tunisia
Socket filling: €80-150. Sinus lift: €300-500 per side. Major reconstruction: €800-1,200. Included in most All-on-4/6 quotes when needed. Compare with €800-3,000 for the same procedures in France.
Missing bone doesn't rule out implants — it adds a step. The scan decides: either you're a direct candidate, or you go through a graft. The Tunisia Smile quote always includes this case — no surprise on arrival.