There is a couple reason why you would need Bone Graft at the time of Implant placement the two most common would be post extraction Implants and Implants in the Sinus area. Post extraction Implant require bone grafting material to cover any defects were the prefabricated straight Implant body might no match 100% your tooth extracted or the shape of your bone. It is important that your Implant is fully covered by bone for a long lasting treatment. The other scenario could be a Sinus Lift when we have been missing upper 2nd premolar, 1st molar or 2nd molars for a long time we can have minimal bone between your gums and the sinus. In this case we would be required to place Bone Graft material and place an Implant at the same time. The ability to place Implants at the time of the Bone Graft depends on the amount of good bone levels between the sinus floor and the crest of the bone. Normally, around 5 mm of bone is needed for the Surgeon to be able to find primary stability for the Implant. If the Surgeon cannot find primary stability then the Implant has a high risk of failure and/or will run the risk of poor angulation for the restorative phase. The advantage of placing the Implant along with the Sinus Lift procedure is that the patient will not require another surgery in that area and the Osseointegration time is reduced.