Figures 1–4. Figure 1. This intra-oral view of the anterior mandibular defect shows significant loss of ridge height. Although implants could have been placed, the restorations would have been long, unattractive, and difficult to clean. Figure 2. Preoperative panoramic radiograph. A significant vertical bone defect is evident in the anterior mandible. Figure 3. A vestibular incision is employed to expose the bony ridge. This location offers optimal vascularity to the planned bony components (basal and transportable segments), most readily exposes the operative site, permits fixation of the distraction device via a simple, straight-line incision with no need for relief, and facilitates closure using a continuous, horizontal mattress suture. Figure 4. A full thickness reflection is employed to gain access to the mandibular defect