Vertical bone reconstruction in posterior maxilla

Hello everyone,
Today we present a clinical case of vertical bone reconstruction in posterior maxilla, referred to us by a colleague. The patient, a 43-year-old male, suffered from localized periodontal disease affecting his upper left molars. Due to severe mobility and a hopeless prognosis, we extracted the teeth.

Tunnel approach for vertical bone reconstruction

Two months post-extraction, the site presented a vertical bone defect of approximately 10 mm. To avoid dehiscence and improve graft integration, we used a tunnel approach combined with the Khoury box technique.

We adapted two thin autogenous cortical bone plates to form a box-like structure. Inside this frame, we packed particulate autogenous bone to promote rapid vascularization and ensure volume stability. This method is ideal for vertical ridge augmentation in posterior sites, where access is limited and precision is critical.

Implant placement and healing stages

Four months after the grafting procedure, we reopened the site. The regenerated bone allowed for precise placement of two implants with adequate bone on all sides.

After another four months, we performed the second-stage surgery and placed healing abutments. The soft tissue showed good adaptation, and the final bone volume remained stable.

A follow-up X-ray illustrates the full sequence: bone defect, vertical bone reconstruction in posterior maxilla, implant placement, and final healing.

Learn this approach step by step

📎 Want to see more vertical ridge augmentations like this one? Visit our clinical case section for real examples and surgical breakdowns.

We hope this case gives you insight into managing posterior vertical defects with predictability and long-term success.