Vertical and horizontal augmentation presents one of the greatest challenges of bone regeneration in implant dentistry. This is primarily due to the difficulty of the surgical procedure and its potential complications. However, it has been demonstrated that successful clinical outcomes can be predictably achievable when strict protocols are followed. The detailed understanding of clinical anatomy should guide the clinician when managing the soft tissue flaps in an attempt to securely close the flaps to achieve optimal healing environment of the graft. Graft immobilizations, the optimal use of graft materials are essential in achieving bone formation even in a distance from the bony walls. This presentation will summarize the essential steps of ridge augmentation and gives an insight how a clinician can learn these demanding procedures.