Inferior border rib grafting appears to be a useful procedure in providing bony augmentation for severely atrophic edentulous mandibles. Major advantages to the prosthodontic patient are that (1) remodeling and changes in the denture-bearing surfaces are minimal following surgery, (2) the interocclusal space is unaltered, (3) in nonunion body fractures occurring in severely atrophic mandibles, the ribs applied to the inferior-buccal and inferior-lingual aspects of the mandible hold the fragments in a much more favorable position, thus preventing superior elevation of the posterior segment and inferior displacement of the anterior segment, and (4) resorption rates seem acceptable. The patient should be informed of possible consequences. As with all preprosthetic special procedures, a psychosocial analysis may also be indicated.