Quick answer
A periodontal bone graft around a natural tooth usually costs $650–$1,500 for one site, and $1,000–$2,400 when two or more adjacent sites are treated. It is often combined with flap surgery, which adds to the total. Insurance is more likely to cover it than an implant-related graft because it treats periodontal disease.
At a glance
- One site
- $650 – $1,500
- Two adjacent sites
- $1,000 – $2,400
- Often combined with
- Flap surgery, scaling, membrane
- Membrane add-on
- $300 – $800
- Coverage
- Often 50–80% when documented as periodontal therapy
Most bone graft content is written for people preparing for an implant. A periodontal bone graft is a different problem: the tooth is still there, and the goal is to rebuild bone that periodontal disease has destroyed around it. The procedure, the price and the insurance logic are all different.
What a periodontal bone graft does
Periodontitis damages the tissues that hold a tooth in place. The gum pulls away, the pocket deepens, and the bone that supports the root resorbs. In some defects — particularly narrow, vertical defects — a surgeon can place graft material into the bony pocket to encourage the body to fill it with new bone.
The graft is usually combined with:
- Flap surgery, which lifts the gum so the defect can be seen and cleaned.
- Scaling and root planing, before or during surgery, to remove the bacterial deposits that caused the defect.
- A barrier membrane, to keep gum tissue from growing into the bone space.
- A biologic, such as enamel matrix derivative, in selected defects.
It is not a substitute for periodontal maintenance. The surgery changes the anatomy; the follow-up controls the disease.
The cost
| Situation | Planning range |
|---|---|
| One periodontal defect, graft only | $650 – $1,500 |
| One defect with flap surgery | $1,000 – $2,200 |
| Two adjacent sites | $1,000 – $2,400 |
| Membrane or biologic | $300 – $800 add-on |
| Sedation | $200 – $800 add-on |
| Follow-up periodontal maintenance | $150 – $300 per visit, ongoing |
These are cash-pay planning ranges for 2026. They exclude the initial consultation, full-mouth radiographs, a cone-beam CT if needed, and any extractions.
Why the range is wide
The defect shape. A narrow three-wall defect holds graft material well. A wide one-wall defect or a furcation involvement is harder to rebuild and may need a different approach.
The tooth. A single-rooted anterior tooth is easier to access than a molar with furcation involvement. Upper molars may need a sinus check; lower molars sit near the nerve.
The technique. A graft alone is less expensive than graft plus membrane plus biologic. The surgeon chooses based on the defect and the evidence for each combination.
The city. Rent, wages and the number of periodontists nearby change the fee. There is no reliable national average that survives a local quote.
Is it covered by insurance?
Periodontal bone grafting is more likely to be covered than implant-related grafting because it treats a diagnosed disease. Many plans pay 50–80% of the allowed fee after a deductible, subject to the annual maximum.
The claim needs:
- A periodontal diagnosis with probing depths and attachment loss.
- Radiographs showing the defect.
- The correct CDT code for the graft and any membrane.
- A narrative explaining why the graft is necessary rather than optional.
- Pre-authorisation, if the plan requires it.
A plan may still deny the claim as “experimental” or “not medically necessary” if the documentation is thin. Ask the office to submit a pre-treatment estimate before surgery.
Will it save the tooth?
Sometimes. Periodontal regeneration can improve a defect, but it does not guarantee the tooth will last. The evidence is strongest for certain narrow defects and weakest for wide, furcation-involved molars.
Factors that matter:
- Remaining bone. A tooth with very little support is less likely to benefit.
- Mobility. A tooth that is already mobile may need splinting or extraction.
- Smoking. Smoking impairs healing and reduces the chance of a good result.
- Diabetes control. Poor glycaemic control affects wound healing.
- Oral hygiene. Without plaque control, the disease returns around the graft.
- Maintenance. Regular periodontal maintenance is part of the treatment, not an optional extra.
A periodontist should be willing to explain when a graft is unlikely to help and when extraction plus an implant, bridge or denture is the more predictable option.
Periodontal graft vs implant graft
| Periodontal graft | Implant-site graft | |
|---|---|---|
| Goal | Rebuild bone around a natural tooth | Rebuild bone to hold an implant |
| Typical site | A periodontal defect | An extraction socket or narrow ridge |
| Common codes | D4263, D4264, D4266/4267 | D7953, D6104 |
| Insurance | More often covered | Often excluded or limited |
| Timeline | Healing 3–6 months, then maintenance | 3–6 months, then implant |
The two procedures use similar materials but different biology and different success criteria. Do not compare their prices as if they were the same operation.
Questions to ask the periodontist
- What type of defect do I have, and what is the evidence that grafting will help?
- Is a membrane or biologic planned, and why?
- What are the alternatives — deep cleaning, extraction, implant, monitoring?
- What happens if the graft fails or the tooth remains mobile?
- How often will I need maintenance after surgery?
- What is the total cost, including follow-up?
The bottom line
A periodontal bone graft costs roughly $650–$1,500 for one site and $1,000–$2,400 for two, often plus flap surgery and a membrane. Insurance may cover half or more when the claim is documented as periodontal therapy. It can improve a suitable defect, but it is not a cure for periodontal disease and it cannot save every tooth.
For the full procedure comparison, read what is a dental bone graft. For implant-related pricing, see the cost guide.
Frequently asked questions
What is a periodontal bone graft?
It is a procedure that places bone graft material into a defect in the jawbone around a natural tooth, usually after periodontal disease has destroyed supporting bone. It may be combined with a flap, a membrane or enamel matrix derivative to encourage regeneration.
How much does periodontal bone grafting cost?
One site typically costs $650–$1,500. Two adjacent sites commonly run $1,000–$2,400. Flap surgery, a membrane, a biologic or sedation may be billed separately, so ask for a line-item estimate with CDT codes.
Does insurance cover a periodontal bone graft?
More often than an implant-related graft, because it treats periodontal disease. Many plans pay 50–80% after a deductible, subject to an annual maximum. The claim needs a periodontal diagnosis, probing depths, radiographs and the correct code.
Can a bone graft save a loose tooth?
Sometimes it can reduce a defect and improve support, but it does not reverse all periodontal disease and it cannot save every tooth. Success depends on the shape of the defect, remaining bone, plaque control, smoking and medical factors. A periodontist has to probe and image the tooth first.
Is periodontal bone grafting the same as deep cleaning?
No. Deep cleaning removes plaque and calculus from below the gum line. A bone graft is surgery that adds material to a bony defect. Some patients need both, in sequence, and some need only non-surgical treatment.
How long is recovery after a periodontal bone graft?
The gum tissue usually closes in one to two weeks. The graft consolidates over three to six months. Most patients manage discomfort with over-the-counter pain relief and avoid chewing on the treated side for several weeks.