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This case report describes a patient who had severe mandibular bony deficiency as a result of excision of aggressive central giant cell granuloma. The defect was reconstructed with iliac bone graft. Four years later vertical distraction osteogenesis was performed on the grafted mandible in order to obtain a satisfactory bony height of mandibular ridge. Distraction osteogenesis can be a good alternative for the reconstruction of mandibular deficiencies.