Vertical and horizontal bone augmentation with the intraoral autogenous J-graft

This article describes a technique to predictably reconstruct both horizontal and vertical bony defects with one graft, the autogenous J-graft. Bone harvested from the ramus is contoured in three dimensions resulting in both a horizontal and a vertical component. When there is inadequate soft tissue due to the increase in bone volume at time of augmentation, the bone graft is combined with a pedicle palatal connective tissue graft. This provides both a source of blood supply and soft tissue to the grafted site. There are several advantages to the J-graft technique; a single procedure can reconstruct complex three-dimensional defects and improve blood supply to the graft due to the larger buccal (horizontal) component in contact with the host bone which then supports the smaller occlusal (vertical) component. Finally, bone is added to interproximal sites as it curves from the buccal to the palatal against adjacent teeth. This supports the papilla at the future implant site. The autogenous J-graft is the ideal technique for augmentation in the esthetic zone with significant resorption that includes interproximal sites.