Obtaining proper occlusal clearance to allow for a single unit crown restoration is a fundamental prerequisite for dental implant restoration. Long-standing edentulous sites are often fraught with disuse atrophy and unopposed supra-eruption of the opposing dentition. In the posterior maxillae/mandible, there are vital structures that have to be mobilized in order to allow space for either bone transposition or onlay/inlay grafting. There are several predictable techniques described to address these preprosthetic alveolar deficiency dilemmas [1–3].

The osteoperiosteal flap technique has made a strong contribution towards management of these defects. Mobilizing a segment of alveolus attached to the overlying soft tissue can obtain uni- or bi-directional augmentation. This case report describes an amplification of a vertical osteoperiosteal flap with concomitant placement of dental implants in a partially edentulous dental arch.