In conventional segmental sandwich osteotomy technique the moving the transport segment inferiorly to increase the vertical height causes the segment to move bucco-palatally, increasing the horizontal defect. So using the computer guided in segmental sandwich osteotomy and fixation the transport segment hopefully will reduce the bucco-palatal tipping.

Inclusion Criteria:

• Patients with vertically deficient anterior maxillary ridge a minimum 10 mm. height of alveolar bone.
• Patients with medical history that did not hinder implant placement (uncontrolled diabetes) and adequate proper oral hygiene.
• Patients of adequate alveolar bone width.
• Both genders males and females will be included.

Exclusion Criteria:

• General contraindications to implant surgery.
• Subjected to irradiation in the head and neck area less than 1 year before implantation.
• Untreated periodontitis.
• Poor oral hygiene and motivation.
• Uncontrolled diabetes.
• Pregnant or nursing.
• Substance abuse.
• Psychiatric problems or unrealistic expectations.
• Severe bruxism or clenching.
• Immunosuppressed or immunocompromised.
• Treated or under treatment with intravenous amino-bisphosphonates.
• Lack of opposite occluding dentition/prosthesis in the area intended for implant placement.
• Active infection or severe inflammation in the area intended for implant placement.
• Need of bone augmentation procedures at implant placement.
• Unable to open mouth sufficiently to accommodate the surgical tooling.
• Patients participating in other studies, if the present protocol could not be properly followed.
• Referred only for implant placement or unable to attend a 5-year follow-up.
• Requiring only single implant-supported crowns.