The aim of this presentation is to describe the methodology and outcome for the management of local bone deficiencies and jaw atrophy often encountered in implant dentistry. Clinical material describing the use of block grafts harvested from the ramus and the symphysis for the management of local bone deficiencies will be described .The use of grafts from the iliac crest for the reconstruction of atrophied jaws will also be presented. Diagnostic surgical and restorative aspects will be covered. Clinical data gathered over 14 years will be presented as well as aesthetic and functional outcomes. Biological healing principles and their application in clinical practice to achieve predictable and stable outcomes will be described.