A lady patient wants Implant supported bridge in Upper anterior edentulous region.
The Teeth in that region have been lost about 20 years ago. She has already under gone plenty of other treatments so is reluctant for Onlay grafts. I have taken CT Scan to see Axial sections as well as done ridge mapping with special tool. It seems the crest is about 3 mm and then on apically gradually increases to about 10 mm apically (labio lingualy). My query is whether I can attempt Bone plate expansion with D expanders and then put implants or this case needs an onlay Graft (which she isn’t interested in). I have seen Dr Salama’s video where he puts Bio-oss over the labial plate like a garnishing and covering with a membrane. Could that approach be a viable alternative. Does that way work? Is there any other easier way to handle this situation? 4 months later cortico Cancellous grafts were taken from the mandible and grafted on to the maxilla

Occlusal View 2
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Dr SDJ
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Occlu. View Lip Retract
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Front view
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X Ray
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Dr SDJ
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This is how the ridge begins
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Dr SDJ
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This is how the ridge is above the molar furcation level
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Dr SDJ
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Exposure of recipient site
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Dr SDJ
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Scoring the periosteum
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Dr SDJ
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Donor site in Chin
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Dr SDJ
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Elevation of Graft cortex
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Dr SDJ
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Making holes in the graft
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Dr SDJ
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Securing graft with screws
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Dr SDJ
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