Anatomical variations often present a challenge in the placement of an implant in its optimal location. A ridge split procedure, which had been recommended for narrow alveolar ridges, has recently undergone a number of modifications, making the procedure simpler and providing more predictable outcomes. This article reports the 3-year follow-up of 2 implants placed using a ridge split procedure with a piezoelectric surgical unit for the rehabilitation of the mandibular posterior ridge.