This presentation will describe three ways in which deficient alveolar can be restored to its original dimension to permit the crestal emergence of root form implants within the same circumference as the original roots.

• When normal crestal height is present, natural width may be restored with bone manipulation
• Vertical deficient bone is most predictably restored to a precise height with a vascularized osteotomy and the necessary width correction achieved with bone manipulation at the time of implant placement
• When vertical correction is not possible with vertical osteotomy, irradiated onlay allograft blocks placed with remote incisions are the next choice

Learning Objectives: At completion of this presentation, participants should be able to:
1. Understand the basic concept of each approach to restoration of the deficient alveolar
2. Appreciate the importance of and protection of the blood supply in each approach
3. Avoid incisions over bone grafts
4. Recognize the difference in loading stability between mature and grafted crestal bone