Mandibular Interforaminal Ridge Reorientation for Osteogenic Reinforcement for Knife-Edge and Hourglass Mandibles in the Anterior Region: A Technical Note

Severely narrow interforaminal mandibular ridges with knife-edge or hourglass morphology may compromise implant placement despite preserved vertical height. This technical note describes the Mandibular Interforaminal Ridge Reorientation for Osteogenic Reinforcement technique, a same-site approach in which a crestal cortical segment is mobilized and reoriented outward to create a contained tunnel for particulate grafting under a titanium-reinforced dense polytetrafluoroethylene membrane. The surgical workflow includes controlled osteotomies, stabilization of the mirrored segment, tunnel grafting, and tension-free closure. In a consecutive series of five cases, cone beam computed tomography at 6 months showed a mean horizontal gain of 4.08 mm, enabling implant placement in all cases and continuation of the planned prosthetic rehabilitation. Mandibular Interforaminal Ridge Reorientation for Osteogenic Reinforcement may represent a pragmatic option for selected anterior mandibular atrophies with preserved height, avoiding donor-site morbidity. Further clinical studies are required to validate its predictability. (c) 2026 The Authors. Published by Elsevier Inc. on behalf of the American Association of Oral and Maxillofacial Surgeons. This is an open access article under the CC BY license (http://