S.M.A.R.T. Bone Grafting in Rancho Mirage, CA
A minimally invasive approach to rebuilding selected areas of deficient jawbone before dental implant treatment.
Dr. Rod Strober evaluates the location and extent of bone loss, gum-tissue health, implant plan, medical history, and restorative goals before determining whether S.M.A.R.T. bone grafting or another augmentation technique is appropriate.
Rebuilding selected areas of the jaw through a smaller access point.
S.M.A.R.T. stands for Subperiosteal Minimally Invasive Aesthetic Ridge Augmentation Technique. It is designed to add bone volume to selected areas of an alveolar ridge—the portion of the jaw that supports the teeth.
Rather than broadly lifting the gum tissue from the treatment area, the technique uses a smaller access incision and specialized instruments to create a controlled space beneath the periosteum. Planned grafting material is then introduced into that space.
The objective is to develop sufficient bone volume for a future dental implant while preserving the surrounding soft-tissue architecture whenever the clinical situation allows.
Dental implants require an appropriate foundation.
Bone dimensions, density, anatomy, gum tissue, implant position, and the final restoration all influence whether grafting is needed.
Changes after a tooth is removed
The ridge can gradually change in width and height after tooth loss, potentially reducing the available foundation for an implant.
Bone loss around natural teeth
Periodontal disease can damage the tissues and bone that support teeth, leaving an uneven or deficient ridge after tooth loss.
Damage from an abscess or failed tooth
Infection, root fractures, and other dental conditions can affect the surrounding bone before or during extraction.
Injury to the teeth or jaw
Dental trauma may damage the bony ridge and change the location or amount of bone available for a replacement tooth.
A naturally narrow ridge
Some patients naturally have a ridge that is too narrow for the intended implant size or position without augmentation.
An older extraction or implant site
A site treated years earlier may require additional evaluation or reconstruction before a new implant plan can proceed.
A different surgical approach to selected ridge defects.
S.M.A.R.T. is not automatically the best technique for every bone defect. Its advantages depend on the anatomy, treatment location, soft-tissue condition, materials used, and clinician’s assessment.
The defect, the patient, and the final implant plan must be considered together.
- Three-dimensional imaging of the treatment area
- Ridge width, height, shape, and defect location
- Position of nerves, sinuses, and neighboring roots
- Thickness and health of the gum tissue
- Condition of adjacent teeth and existing implants
- The intended implant size, position, and restoration
- Previous grafting, extractions, infections, or trauma
- Medical conditions, medications, and healing history
- The bone defect is not appropriate for tunneling access
- Significant vertical augmentation is required
- Active infection must be treated before grafting
- Soft-tissue conditions limit predictable closure
- Medical risk factors need additional management
- Smoking or nicotine use compromises healing potential
- A sinus procedure or another specialized graft is needed
- Specialist management is more appropriate for the case
Detailed planning before graft material is placed.
The exact procedure varies by site. Dr. Strober will explain the planned graft materials, anesthesia, surgical steps, healing period, potential risks, and relationship to future implant treatment.
Schedule an EvaluationExamine the treatment site
The teeth, gum tissue, bite, available ridge, medical history, and intended implant restoration are reviewed.
Evaluate the bone in three dimensions
Appropriate imaging helps identify the dimensions of the defect and its relationship to neighboring anatomical structures.
Design the graft around the implant goal
The location and amount of augmentation are planned according to the future implant position and final restoration.
Create a controlled subperiosteal space
After anesthesia, a smaller access incision and specialized instruments are used to develop a pouch beneath the periosteum.
Place the planned graft material
The selected graft material and any planned biologic components are introduced into the prepared space to support bone formation.
Secure the access area
The incision is closed according to the treatment plan, and detailed postoperative instructions are provided.
Evaluate healing over time
Follow-up visits allow the team to monitor the tissue, symptoms, grafted area, hygiene, and readiness for the next treatment phase.
The material used should match the treatment plan.
Bone-grafting procedures may use donated human bone, animal-derived material, synthetic material, a patient’s own bone, biologic components, or a planned combination.
Each option has different handling properties, indications, limitations, and healing characteristics. The material used for your procedure will depend on the defect, medical history, implant plan, and Dr. Strober’s clinical assessment.
Before treatment, the team will review the planned materials and any relevant alternatives with you.
Bone development cannot be reduced to one universal timeline.
Healing depends on the location and size of the graft, material used, tissue quality, medical health, nicotine exposure, oral hygiene, and individual biological response.
Protect the surgical site
Initial care focuses on protecting the incision, controlling plaque, following dietary instructions, and managing expected postoperative symptoms.
Monitor the tissue response
Dr. Strober evaluates the site for appropriate closure, tissue health, infection, graft exposure, and other healing concerns.
Allow regeneration and remodeling
The grafted site requires time for new bone formation, incorporation, maturation, and remodeling.
Confirm readiness for implant treatment
Clinical evaluation and imaging may be used to determine whether the site has developed sufficient bone for the planned implant.
Proceed when the site is ready
Implant placement may be staged after graft healing. In selected situations, grafting and implant placement may be coordinated differently based on stability and anatomy.
Follow the instructions provided for your specific graft.
The team will tailor postoperative directions to the treatment area, surgical approach, anesthesia, medications, and implant plan.
Protect the grafted area
Avoid touching, pulling, or placing unnecessary pressure on the surgical site.
Follow dietary instructions
Select foods and chewing patterns that protect the treatment area for the period directed by the office.
Maintain careful oral hygiene
Clean the surrounding mouth as instructed without disrupting the graft or incision.
Use medication only as directed
Follow the individual instructions provided for pain medication, antimicrobial rinses, antibiotics, or other prescribed care.
Avoid smoking and nicotine
Nicotine exposure can interfere with blood flow, soft-tissue healing, bone formation, and implant treatment.
Attend every follow-up visit
Monitoring allows the team to identify concerns and determine when the site is ready for its next phase.
Call about worsening symptoms rather than waiting for your next visit.
Contact Country Club Dentistry for increasing swelling, fever, persistent bleeding, drainage, medication concerns, worsening pain, graft exposure, or another unexpected change. Seek emergency medical help for difficulty breathing or swallowing or rapidly spreading facial or neck swelling.
The graft should be planned around the final tooth replacement.
Bone grafting is not an isolated step. The desired implant location, angle, diameter, surrounding gum tissue, bite, and final crown or full-arch restoration should guide the augmentation plan.
Dr. Strober’s implant and restorative experience allows the surgical foundation and final restoration to be considered together from the beginning.
Implant planning informed by more than three decades of dentistry.
Dr. Rod Strober has practiced dentistry since 1993 and provides comprehensive implant, restorative, cosmetic, and general dental care at Country Club Dentistry.
In 2019, he achieved Mastership from the International Dental Implant Association after completing extensive continuing education and documented implant-placement experience.
His approach considers whether grafting is necessary, which method best fits the defect, how the site relates to the future implant, and what restorative design will support function and appearance.
Complex anatomy or treatment needs may require coordination with an appropriate dental or medical specialist.
Answers before your consultation.
An examination and appropriate imaging are required to determine whether this approach fits your anatomy and implant plan.
01 What does S.M.A.R.T. stand for?
S.M.A.R.T. stands for Subperiosteal Minimally Invasive Aesthetic Ridge Augmentation Technique. It is a tunneling approach used to augment selected deficient areas of the jaw.
02 How is it different from traditional bone grafting?
The published S.M.A.R.T. approach uses a smaller access incision and creates a subperiosteal pouch rather than broadly elevating a conventional surgical flap across the treatment area. Not every defect is suitable for this method.
03 Why might I need bone grafting before an implant?
Bone grafting may be recommended when the available ridge does not provide the volume, contour, or location needed for the planned implant and restoration.
04 Is S.M.A.R.T. bone grafting right for every patient?
No. Candidacy depends on the type and location of bone loss, anatomy, soft-tissue health, implant plan, medical history, nicotine exposure, and other clinical factors.
05 What graft material will be used?
Grafting materials vary. Depending on the case, treatment may involve donor bone, animal-derived material, synthetic material, the patient’s own bone, biologic components, or a combination. Your planned materials will be reviewed before treatment.
06 Is the procedure painful?
Local anesthetic is used during the procedure. Postoperative soreness, swelling, bruising, or tenderness can occur and varies according to the site, extent of treatment, and individual healing response.
07 How long does bone graft healing take?
Healing time varies and may require several months. The graft location, size, materials, overall health, nicotine exposure, and biological response all affect the timeline.
08 Can my dental implant be placed at the same time?
Some grafts can be coordinated with implant placement, while other sites require staged treatment. The decision depends on available bone, implant stability, anatomy, and the extent of augmentation required.
09 How will Dr. Strober know when the graft is ready?
Clinical examination and, when appropriate, updated imaging are used to evaluate healing and whether sufficient bone has developed for the planned implant.
10 Can I smoke after bone grafting?
Smoking and nicotine can interfere with blood flow, soft-tissue healing, bone regeneration, and implant outcomes. Discuss all nicotine use with Dr. Strober before treatment.
11 What are the possible risks?
Possible risks include pain, swelling, bruising, bleeding, infection, incision opening, graft exposure or loss, inadequate bone development, injury to nearby structures, and the need for additional treatment. Risks vary by treatment location and medical history.
12 How do I schedule a consultation?
Request an appointment online or call Country Club Dentistry at (760) 832-7915.
Patient Education Resources
This page provides general information and does not replace an examination, diagnosis, informed-consent discussion, or personalized surgical recommendation.
Suite A & B
Rancho Mirage, CA 92270
9:00 AM–5:00 PM
Build the foundation before rebuilding the smile.
Schedule a consultation with Dr. Rod Strober to evaluate your bone volume, implant options, grafting needs, and the most appropriate path toward tooth replacement.