The bone volume then becomes insufficient and contra-indicates the placement of implants whose number, size and position must allow to achieve an effective, aesthetic and sustainable prosthesis.

This intervention aims to restore bone volumes that have become insufficient.

Once rebuilt, these will form the solid and indispensable foundation of the implant-fixed prosthesis.

The principle is to bring some bone to the site to rebuild. This grafted bone is gradually "accepted" by the recipient site and allows the placement of dental implants, usually 3 to 6 months after reconstruction.

When the restored bone volume is very important or when the gingiva is too thin, a gesture of mucosal management may be necessary. It is often performed before or during the placement of implants.

The reference material remains the autologous bone, ie your own bone tissue. It eliminates any risk of contamination by a possible infectious agent from another organism.

It is most often taken from the lower maxillary (ramus, symphysis), sometimes on the cranial vault and exceptionally on the hip (iliac crest), in the form of chips or platelets.

Other materials are used in common practice, biomaterials.They come from another individual (allograft) or another species (xenograft of bovine or porcine origin most often). Seductive because they avoid the sampling step, they do not allow all types of reconstruction.

A radiological assessment is essential. It includes a dental panoramic and often a digital tomography or a dentascanner.

Sometimes other examinations are required to evaluate the bone to be taken (teleradiography, scanner).

Three methods are possible:

• Pure local anesthesia, where an analgesic product is injected locally to ensure the insensitivity of the treated areas.

• Thorough local anesthesia with intravenous tranquilizers ("vigilant" anesthesia or neuroleptanalgesia).

• Classic general anesthesia, during which you sleep completely.

The choice between these different techniques will be the result of a discussion between you, the surgeon and the anesthesiologist.

The intervention can be done externally (you leave 30 to 60 minutes later), "outpatient", that is to say with an exit the same day after a few hours of surveillance.

Sometimes a short hospitalization may be preferable. The entrance is then in the morning (or sometimes the day before in the afternoon) and the exit is allowed the next day.