Closed Approach for Horizontal Augmentation of the Maxilla

The narrow ridge in the anterior maxilla often requires horizontal augmentation for ideal implant placement. This article reviews the historical use of a closed, tunnel approach to augment deficient alveolar ridges and describes its application for augmentation of the narrow ridge in the anterior maxilla. The use of a tunnel approach through a vertical incision in the unattached mucosa provides access to the ridge while maintaining crestal attachments without displacement of the crestal attached gingiva. This approach is atraumatic and provides excellent access for placement of graft material for ridge augmentation.