Patients with atrophic alveolar bone have a variety of different presentations, including vertical versus horizontal atrophy, anatomic features such as flat vs sloped defect walls or concavities, various bone density (eg cortical vs cancellous bone).
Each of these features can affect the efficacy of bone augmenta- tion, either in a favorable or unfavorable manner. The oral location (posterior vs anterior maxilla, post vs anterior mandible) requires special considerations. Therefore, the approach utilized needs to thoroughly analyze and classify the site and patient characteristics in order to select an appropriate technique, material and protocol. Another consideration is the potential of complications for the selected protocol and a risk assessment to determine the likelihood of encountering negative outcomes, based on patient features. Three dimensional reconstruction of the alveolar bone requires several components for successful bone regeneration. The components for 3D reconstruction include 1) Bone substitute (allograft or xenograft), 2) osteogenic cells, 3) osteogenic signals (growth factors), 4) blood supply, 5) and wound stabilization. Many controversies remain, including whether, a) membrane are really necessary, b) primary closure or open healing concept, The protocol presented for 3D reconstruction of alveolar bone and mucosa will increase the likelihood of successful outcome and reduces the potential for complications.