The posterior mandible is the most difficult area to reconstruct, according to our experience. The vertical expansion technique, called "sandwich" osteotomy, frequently cannot be used. Alveolar distraction has a lot of drawbacks: patient constraints, uncertain outcome, and high risk of complications. Guided bone regeneration is restricted to small deficits. The onlay graft technique is poorly documented although it has many assets as demonstrated by our study. It may be used in any situation, even the most severe cases, except for rare cases of reduced occlusal space.