Aim: To introduce a new device and technique to widen a narrow alveolar crest prior to implantation.

Materials and methods: A new distractor was used to widen a narrow alveolar crest. Under local anesthesia, 3 mucoperiosteal incisions were performed; One along the crestal ridge and two vertical incisions at the anterior and posterior buccal aspects. Through these incisions, bone cuts were made without stripping the mucoperiosteum. The bone transport was fractured by an osteotome and the distractor was inserted into the crestal bone cut. Distraction started 7 days post-op and was stopped when adequate width was achieved. Consolidation period was 1 week and than removed under local anesthesia. Implants inserted at the same session.

Results: 35 patients who suffered from a narrow alveolar crest were treated over 2 1/2 years. Amount of crest expansion was 4–8 mm. 1 case failed due to partial denture placement by the patient against the instructions. 33 patients had 79 implants placed. 28 patients prosthesis completed. 1 complications of bone loss and implant neck exposure (The only case that the bone was stripped). 3 implants failed to osseointegrate at the first try and were replaced successfully 8 weeks later. No complications were observed 18–30 months after prosthetic treatment.

Conclusions: Crest widening by distraction may be a better alternative to bone augmentation in cases of narrow crest with sufficient height. The advantages of the new technique are; early implant placement, simple procedure, no painful donor site, no post-op bone resorbtion, the technique can be easily performed in the private office. A long term and multi center trial is needed.