Extensive loss of alveolar bone and teeth in the anterior mandible presents a complex problem for reconstruction. Numerous augmentation techniques are currently in use to create sufficient bone volume for reliable placement of endosseous implants in the case of severely resorbed mandibles. The aim of this report is to assess the efficacy of the piezoelectric sandwich osteotomy for vertical augmentation in the atrophic segment of anterior mandible through clinical and histologic studies. A complete osteotomized segment was made, using the piezoelectric saw, to make a segmented bone in the atrophic edentulous area and the mobile segment was elevated by 10-mm high vertically. Interpositional mineral allograft materials were inserted in the space between the basal bone and the segmented bone. A bone biopsy was performed on the augmented bone region and 3 dental implants were placed simultaneously 6 months later. About 10 mm of vertical gain was achieved by the sandwich technique. Histologic analysis presents new bone formation without inflammatory or foreign body reactions.