The bone volumes to be restored may involve a single edentulous (only one missing tooth) or several teeth or in complex cases a whole dental arch. Restorations may involve only the thickness of bone (horizontal augmentations), or of missing volumes in the three dimensions, thickness and height of bone (vertical augmentations).

There can be several causes of bone resorption, from short-term physiological resorption around the teeth that progresses with age, to tooth loss due to trauma or accidents of various kinds, or even bone volume loss due to periodontal disease, which is not diagnosed in advance and causes tooth mobility with simultaneous bone resorption.

Advanced bone reconstruction surgery is performed only in cases of bone volume deficiency in order to allow functional and aesthetic restoration of chewing.

Nowadays, surgeons have different types of materials available. There is autologous bone, the patient's own bone that is taken from sites in the mouth in order to restore missing volume. Such bone has excellent viability but can undergo resorption if not used properly. Then we have homologous bone, that of cadaveric origin, which under strong controls comes to be used in the mouth. Such bone does not have the same capacity as autologous bone depriving itself after sterilization procedures of many characteristics.  Italian regulations in this regard are fortunately very strict. In addition, there are products of animal or plant origin that can be used only under special conditions, as they lack properties that only autologous bone possesses.

It is clear that the material that is the patient's own is the best, as it is vital bone that possesses superior regeneration and vascularization capabilities to others allowing stability over time with chewing load.

This is a procedure that requires surgical experience and careful preoperative evaluation for the patient, his health status, spoiled habits etc. That is why sometimes alternative materials are recommended, but they do not have the same predictability and as I said are indicated in some clinical situations. All surgeries are not associated with pain or, in any case, if it occurs, in the first postoperative days it is controlled with appropriate medications. The word invasive is a fashionable word to discourage such surgeries because all advanced surgeries with the different techniques are considered invasive.

As I explained earlier autologous bone that is taken from the patient possesses properties of osteogenesis (survival of bone-forming cells), osteoinduction (ability to form bone regardless of where it is transplanted) and osteoconduction (network function for new bone formation). These properties are possessed only by autologous bone.

I had a long experience first in Italy in the field of Periodontology ( the dental discipline that treats periodontal disease ) and then abroad with my teacher Prof Fouad Khoury creator of a technique recognized worldwide that through the use of only autologous bone allows the restoration of lost volumes in a short time.

The thing I emphasize is that all patients are equal in importance, some of them more anxious and with more doubts and questions others less so. I transfer my experience using the maximum amount of material we have available. Certainly it is a procedure that requires surgical attention, but qualitatively and in terms of timing it is not comparable to alternative techniques using synthetic or synthetic bone. Sometimes we allow ourselves to be convinced to perform less invasive routes, but unfortunately that does not give guarantees over time, because regardless of the experience of the operator the quality of the products is another.

The most important thing is to find colleagues who convey trust. The doctor-patient relationship is the basis of any surgical success. Another important thing is to always explain before proceeding what the risks of surgery are, what materials and any implants are used, and what the prosthetic surgical rehabilitation timeframe is.

I personally collaborate with several colleagues in different regions of Italy (see the list below) where anyone who wants can undergo an initial examination.