A tissue punch is a simple and easy way to gain access to underlying bone for dental implant placement. It generally is used when there is 1) excellent ridge width and there will be no bone needed i.e. mandibular posterior 2) excellent keratinized gingiva, and 3) good access to place the punch. Tissue punches are available in five different diameter sizes (3.5mm, 4.0mm, 4.5mm, 5.0mm, 5.5mm).