166 BOOK REVIEW
Book Review
Vertical Alveolar
Ridge Augmen-
tation in Implant
Dentistry: A onlay graft division (2) is divided into
Surgical Manual.
Len Tolstunov.
Hoboken, NJ:
Wiley Blackwell,
368 pages. 2016. ISBN: 978-1-
119-08259-0.
This book focuses on vertical bone
augmentation for dental implant place-
ment. There are 44 contributing authors
and the text is 354 pages divided into 8
sections:
Introduction, Guided Tissue Regen-
eration, Subantral Grafting, Alveolar
Distraction, Autogenous Block Graft-
ing, Free Bone Flaps, Soft Tissue Graft-
ing, and Tissue Engineering.
Although there are some identical
sections and chapters as in the horizon-
tal augmentation text, many have been
written by different authors. In the
preface, the editor explains his desire
to make this text a practical, user
friendly, and clinically relevant surgical
manual. Because of the broad scope of
procedures available for bone augmen-
tation, the author decided to split the
material into 2 volumesdhorizontal
and vertical augmentation. This review
will discuss the volume on vertical bone
augmentation with some references to
the horizontal manual as well.
Section I is the introduction for the
text. It includes diagnosis and treatment
planning concepts. Chapter 1, written by
Dr. Tolstunov, is the same chapter as in
his text on horizontal augmentation. It
introduces a new classification for bone
augmentation procedures. The classifica-
tion is inconsistent and confusing. A table
divides the procedures into (1) inlay
grafts; (2) onlay grafts; (3) distraction
osteogenesis; and (4) vascularized bone
Copyright Ó 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
Craig Misch, DDS, MDS
flaps. Areas of the table are highlighted in
blue, but the reason for this designation is
not clear or explained. In the table, the
particulate and block grafts. The particu-
late section includes guided bone regen-
eration and “tent pole” techniques
(including titanium mesh, screw, or im-
plants). The term “tent pole” is not typi-
cally used to describe mesh-protected
grafts. In the description of the classifica-
tion system on the following page, the first
2 types of procedures are changed from
(1) inlay grafts (2) onlay grafts to (1) par-
ticulate bone grafting and (2) block bone
grafting. Chapter 2 on applied surgical
anatomy was written by Drs Rabie Shanti
and Vince Ziccardi. It is a basic summary
of surgical anatomy that clinicians will
encounter while performing grafting pro-
cedures in the maxilla and mandible.
Chapter 3, written by Dr Steven LoCas-
cio, covers prosthetic evaluation for
implant dentistry. It provides good guide-
lines for vertical space requirements for
various types of prostheses and planning
the edentulous patient. This chapter in the
horizontal text covered more prosthetic
diagnosis and planning utilizing cone
beam computed tomography. Chapter 4
is on the use of orthodontics for implant
site development. It briefly covers space
development, extrusion, and tooth move-
ment to enhance bone width (orthodontic
implant site switching). Chapter 5 dis-
cusses radiographic evaluation for
implant dentistry. It is a good review
focusing mainly on cone beam computed
tomography and diagnostic imaging ob-
jectives. There is less coverage of radio-
graphic anatomy in this text than the
horizontal version. Chapter 6 on the clas-
sification of ridge defects was written by
Dr. Patrick Palacci. It is the same chapter
as in the horizontal augmentation text.
He reviews historical classifications
(Lekholm and Zarb, Siebert) and propo-
ses his own classification. However, the
Palacci-Ericsson classification is more
applicable to the esthetic zone as it focuses
on the papilla. Chapter 7 is also a repeat by
Dr. Alan Herford. He proposes an algo-
rithm for ridge augmentation procedures.
It is a well-organized summary of aug-
mentation techniques including advan-
tages and disadvantages. It would have
been helpful if the editor coordinated
some consistency for the reader between
the various classification systems and
terms used throughout the entire text.
Chapter 8 is on dynamic craniofacial
changes associated with aging. It cautions
clinicians to be aware of alterations that
will occur over time and their impact on
implant treatment.
Section II is on the topic of guided
bone regeneration. Chapter 9 discusses
the use of particulate bone grafts with
guided bone regeneration. The chapter
and clinical examples include membrane
and graft materials for socket grafting and
horizontal defects but very little informa-
tion on vertical augmentation. Chapter 10
is on vertical augmentation with titanium
mesh. It is interesting that this topic is
covered under the section on guided bone
regeneration, as mesh provides space
maintenance but does not act as a barrier
(protected bone regeneration). Drs. Ta-
kahashi and Yamauchi from Japan put
together an excellent presentation with
outstanding clinical documentation. In
chapter 11, Dr. Rolf Ewers wrote on the
pedicled sandwich osteotomy for vertical
bone defects. He discusses the favorable
oral blood supply for the application of
a pedicled bone flap in the posterior
and anterior mandible. A very similar
approach is covered in chapter 12 by Dr.
Dong-Seok Sohn. The use of a Piezoelec-
tric saw well compliments this technique.
Both chapters have well-documented
clinical cases.
Section III covers sinus bone graft-
ing. Chapter 13 is on diagnosis and
treatment planning for the posterior

maxilla. It is an introduction to the topic
and briefly covers diagnosis, treatment
planning, and sinus augmentation ap-
proaches. Chapters 14 and 15 thoroughly
discuss the osteotome technique for sinus
floor elevation, including the hydraulic
technique. In chapter 16, Dr. Sohn dis-
cusses the use of Piezoelectric surgery to
perform sinus windows (lateral and
internal) and the alternative of a platelet
concentrate (“sticky bone”) for bone
augmentation. Chapter 17, on the lateral
approach, is a very short review (6 pa-
ges). Dr. Ole Jensen discusses the poste-
rior maxillary sandwich osteotomy
combined with sinus floor grafting in
chapter 18. This more advanced tech-
nique is useful for severe alveolar atro-
phy to reduce the interarch space for
prosthetic replacement. The manage-
ment of complications is summarized
by Dr. Douglas Kendrick in chapter 19.
Section IV in on alveolar distrac-
tion. In chapter 20, Dr. Stephanie Drew
does an excellent review of surgical
principles and the technique of distrac-
tion osteogenesis. There are also very
nice clinical cases. Chapter 21 covers
the same material but is shorter with
fewer photographs. Chapter 22 also
repeats some concepts but adds clinical
cases of traumatic defects. In chapter
23, Dr. Drew reviews the management
of complications of alveolar distraction.
Section V has only 1 chapter cover-
ing autogenous block bone grafting for
vertical augmentation. The harvest of
bone from various donor sites is dis-
cussed, including the chin, ramus, iliac
crest, and calvarium. There is a lack of
much discussion of recipient site prepa-
ration for block grafting or complications.
The chapter veers off subject and includes
a review of bone graft materials, distrac-
tion osteogenesis, nerve lateralization,
and recombinant bone morphogenetic
protein 2 (rhBMP-2) bone grafting. How-
ever, there are good clinical photographs.
Section VI, on free bone flaps, also
has only 1 chapter that is 7 pages. It
mainly discusses the harvest of a free
fibula osteocutaneous flap for the
All Book Reviews are the sole wording and opinions of the reviewer; and are not those of the Editorial Staff, the Editor-
In-Chief, the International Congress of Oral Implantologists, or of the publisher, Lippincott, Williams and Wilkins.
Copyright Ó 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
IMPLANT DENTISTRY / VOLUME 26, NUMBER 2 2017
reconstruction of larger composite de-
fects and subsequent placement of dental
implants. Other osteocutaneous flaps
(scapula, forearm, iliac) are reviewed.
Section VII covers soft tissue graft-
ing for implant site development. Chapter
26 is on diagnosis and treatment plan-
ning. It is well organized and provides
a decision tree for site development. Soft
tissue grafting techniques are reviewed
by Dr. Suhail Boutrous and Dr. Georgios
Kotsakis in chapter 27. They discuss free
gingival and connective tissue grafts,
pedicle flaps, and allogenic dermal grafts.
They also cover treatment planning and
sequencing of soft tissue grafting proce-
dures. Numerous clinical cases exhibit
the various techniques. In chapter 28,
they nicely review the management of
complications of soft tissue grafting. This
entire section is an improvement over the
same one by different authors in the
horizontal text.
The last section of the book (VIII) is
on the topic of tissue engineering. Chap-
ter 29, written by Dr. Robert Marx, is the
exact same chapter as in the horizontal
text. He expertly discusses the use of
recombinant bone morphogenetic protein
2 (rhBMP-2) and covers the biology of
the growth factor including its clinical use
with titanium mesh for ridge augmenta-
tion. There are good clinical photographs
and histologic samples are included.
Chapter 30, on the use of bone marrow
aspirate, is by Dr. Dennis Smiler. The
technique is nicely documented.
Although the author presents an optimis-
tic perspective on this clinical application,
there is minimal evidence on its routine
use for vertical bone augmentation. The
last chapter is on tooth/alveolar complex
regeneration using tissue engineering.
This is a look into the future at the
possibility of developing teeth and their
associated supporting structures for trans-
plantation. I am surprised neither text had
much material on the other clinically
available growth factor, recombinant
platelet-derived growth factor.
This manual is a collection of
numerous authors who share their
167
various clinical approaches to vertical
ridge deficiencies. There are many well-
known clinicians who contributed to the
text. The advantage of having several
authors is that various perspectives are
shared with the reader. However, there is
some lack of coordination, as a few
chapters repeat information. Two sec-
tions of this book have only 1 chapter
(free bone flap and block bone graft). The
free bone flap chapter could have been
incorporated into the block bone grafting
section. The block bone grafting section
could have been expanded and divided
into more focused categories. There are 4
chapters that are repeats found also in the
horizontal text. I found it interesting that
the editor invited different authors to
cover the same topic in the horizontal and
vertical texts instead of repeating these
chapters in both. It does provide some
additional uniqueness to each book.
As discussed in the previous review,
the print size is noticeably small and
somewhat straining to read. The print
size may have been limited to reduce the
pages and make the text more conve-
niently managed. The chapters are well
referenced and include several good
quality color photographs and figures to
describe the clinical techniques.
The vertical augmentation surgical
manual should be sold as a 2 volume set
with the horizontal text, as the 2 books
are complimentary. Dr. Tolstunov
stated that he wanted to provide a clin-
ically relevant surgical manual one
could “take to the operative room” and
follow. The 2 manuals he has edited are
indeed meant for both novice clinicians
who want to learn more about bone aug-
mentation and experienced surgeons
looking to refine their craft.
Craig Misch, DDS, MDS
Clinical Associate Professor,
Department of Periodontics and
Prosthodontics,
University of Florida School of
Dentistry,
Sarasota, FL,
misch@bonegraft.com