Loss of bone in the mandible after tooth removal is associated with anatomic and aesthetic complications and instability of the mandibular complete denture. This continuing bone loss is not limited to alveolar bone; portions of the basal bone may also be resorbed. Thus, mandibular complete denture is the most unstable, unretentive, conventional prosthesis fabricated in routine dental practice. Root-form endosteal implants cannot always be placed in advanced atrophic mandibles without autogenous bone grafting (from either the iliac hip crest or another site) or bone regeneration. The ramus frame implant (RFI) is indicated when the atrophy in the mandible is advanced. An RFI is an immediate, totally implant-supported prosthesis, which can use homologous grafting material and platelet-rich plasma for increased bone regeneration. The third-generation RFI provides all of the benefits of the first- and second-generation RFIs as well as improvements provided by computed tomography and computer-aided design/stereolithography applications: planning, simplified placement, improved grafting, predictable manufactured components, and retrievability.