Fifty patients with inadequate bone volume for implant placement were treated with mandibular bone grafts from the symphysis or ramus. The choice of donor site was determined by defect morphology and recipient site location. Although the harvest of bone was associated with low morbidity, the ramus donor site resulted in fewer complications. Implants were placed secondarily following a 4- to 6-month healing period. The onlay grafts exhibited minimal resorption and maintained their dense quality. The symphysis grafts were larger in overall volume, with a corticocancellous morphology. The ramus area provided essentially a cortical graft that was well suited for veneering ridge deficiencies; however, the surgical access in some cases was more difficult than in the anterior mandible.