This patient was referred to our office for a dental implant in the mandibular edentulous area; however, ridge augmentation was determined to be required. Upon initial radiographic survey and clinical exam, it would appear that there would be plenty of bone for the eventual dental implant. However, once the CBCT was taken, one can see that although there is enough vertical height of bone, the width would become an issue as there was significant bone atrophy from years of missing the tooth. In this particular case,… the clincial exam made it appear that ther would be enough width of bone. It turned out that the majority of that ridge thickness was soft tissue rather than hard tissue. The decison was made to perform a selective ridge augmentation procedure to enhance the bone thickness so that a dental implant could be placed. Localized soft tissue flap reflection was done, the cortical plate perforated and particulate cortical bone grafting was placed. The procedure was finished with a resorbable membrane and Vicryl sutures. We anticipate that the added bone thickness will allow us to place a dental implant of acceptable size to ensure a favorable long term prognosis for the patient….stay tuned for documentation of the next steps of the procedure.