## 1 Introduction  
The treatment of edentulous areas with horizontal and vertical atrophy is among the most complex tasks in oral surgery; the positioning of endosseous implants can be difficult and sometimes even impossible without a staged regenerative approach [1]. However, the reconstruction and augmentation of severely resorbed alveolar ridges are reliable procedures today, with the availability of a wide range of possible grafting biomaterials and techniques [2]. The chosen techniques and biomaterials can significantly affect the outcome of bone regeneration procedures, in terms of both bone formation volume and quality and amount of vital bone. When choosing a bone graft, the surgeon should carefully consider its ultimate effect on healing processes in, and around, the alveolar bone at the endpoint of the procedure [3]. Thus, by choosing the right grafting biomaterial, the surgeon can relevantly contribute to a favorable outcome. An autogenous bone graft (e.g., harvested from the maxillary tuberosity, the symphysis of the chin or the external oblique line of the mandible) can be considered the gold standard of bone grafts due to its favorable osteogenic ability [4]; autografts, indeed, promote osteogenesis from their own growth factors, which are capable of differentiating cells into osteoblasts [5]. However, donor site morbidity, a long healing period of at least 6 months, graft resorption and a staged approach that necessitates two surgical interventions are considered important disadvantages and can result in avoidable surgical risks. Therefore, clinicians prefer to use commercially available allografts, xenografts or synthetic bone grafts [6]. Donor site considerations require caution in the recommendation of treatment, and a material that is not autologous, but which is equivalent in implant integration suitability, would clearly generate interest. Hence, this category of biomaterial has become the subject of substantial research. Within this framework, the objective of our approach was to combine the biocompatibility and tissue integration of natural materials with the possibility of accommodating the typical mechanical and physical properties of synthetic ones. Composite grafts mimic the nature of healthy human bone most effectively, as they are both rigid and elastic, compact but porous, dense but viable to cells and vessels. SmartBone(r) (SB(r)), a xeno-hybrid developed and manufactured by Industrie Biomedicine Insubri SA (Switzerland), was devised according to a new concept in composite approach, building on a base of bovine decellularized bone-derived mineral matrix, reinforced with bioresorbable aliphatic polymers and RGD-containing collagen fragments derived from animal-sourced gelatin (RGD is the acronym of the tripeptide arginine-glycine-aspartic acid). Such a new concept of biomaterial assembly allows the patient's cells to grow quickly and efficiently into the graft, while its biopolymers degrade, providing osteoconduction, supporting osteogenesis and finally ensuring perfect integration via complete remodeling [7; 8; 9; 10; 11; 12; 13; 14; 15; 16; 17; 18; 19; 20]. This composite biomaterial resembles human bone microstructure and provides macro-scale properties: an adequate-sized open porosity with a combined rigid-elastic behavior, in combination with surface properties, which ensures cell viability and rapid tissue integration. SmartBone(r) on DemandTM is the custom-made application of SB(r) [21; 22]. The _DICOM_ (i.e., the file type according to Digital Imaging and Communications in Medicine standard) data from the radiological examination with a cone beam computed tomography were converted into a _STL_ file with dedicated medical software. The data were then used for planning of a personalized bone graft to allow final rehabilitation with an implant-supported bridge. In this case report, it was used to design a patient-specific bone graft to allow a rehabilitation of a bone deficient maxilla with a bridge supported by implants.