Implant placement can appear straightforward but often requires assessment of bone quality, sinus anatomy, and soft tissue thickness.

When bone height or width is insufficient, grafting or sinus lift procedures may be necessary for long-term success.

Referral is appropriate when:

- Ridge resorption or bone defect is visible after extraction.

- Implant planning software shows <5 mm bone height to the sinus.

- The patient has systemic factors (diabetes, smoking) increasing implant risk.

An oral and maxillofacial surgeon can perform a bone graft at the time of tooth extraction — under AWOMS policy, patients are not charged extra for this procedure. This approach preserves the site for future implant placement and maintains bone volume for better aesthetics and function.

Collaborating with the restorative dentist ensures seamless prosthetic integration.

When to refer: Any case with anatomical limitations, failed previous implant, or uncertainty about grafting requirements.