This article compares 2 different alveolar distractors: Lead System (LS) and MODUS MDO 1.5/2.0 (M-MDO). This is a clinical retrospective study; 32 distractions were performed. We used the LS distractor (intraosseous) on 24 patients and the M-MDO (extraosseous) on the other 8. The variables included bone alveolar ridge height, alterations of the oral mucosa, number of distractors, implant survival, and complications. We also developed descriptive and univariate statistical analysis. The mean increase of bone height after performing the alveolar distraction was 6.15 mm, 5.74 mm with LS, and 8.36 mm with M-MDO (P < 0.0001). The survival rates of the implants in the intraosseous and extraosseous groups reached 100%. However, the use of M-MDO resulted in a significant defect in the alveolar mucosa during implant insertion (100%), an event that did not occur when using LS (P < 0.001). The most common complication in the intraosseous group was the tilting of the segment (25%), whereas, in the extraosseous group, the main difficulty was the rod interference with the opposing arch (75%). Bone defects after alveolar distraction appeared both in the intraosseous group (66.7%) and in the extraosseous group (50%). Both the LS and the M-MDO distractors are effective for alveolar bone distraction. The choice of one distractor over another depends on the clinical characteristics of each case, such as the size and shape of the defect, the patient's tolerance, the distance to the opposing arch, and the surgeon's experience.