For an implant to be successful, there must be adequate bone available for proper placement. Since the bone and gums will shrink away once a tooth is removed, it is not unusual to have a situation where there is an inadequate amount of bone to place an implant. Simple techniques start with socket preservation where the dentist places a bone grafting material in the socket at the time of tooth removal. Even more predictable is placing a membrane over the graft material. This will allow the graft to heal undisturbed and has a very high rate of success. Once the bone height has shrunk, then a block graft needs to be done to give the bone more vertical. A block graft uses a piece of cortical bone that is obtained from another part of the body. Common areas are the mandibular ramus (the part of the jaw bone that lies behind the lower back teeth) or the mental symphysis (part of the chin). Once a block of bone has been harvested, then a flap of gum is peeled back at the donor site and the block is held in place with screws. Since the procedure utilizes bone from the same person, it doesn’t reject the graft. After allowing the area to heal for a few months, then the site will be ready for implant placement.