A method of performing an osteotomy in the maxilla using hand instruments was recently introduced in The Compendium (February 1994). This new procedure is called the osteotome technique. Part of this previous article described a means of placing implants in locations that are too thin to permit the use of standard implant drills. A bone enlargement technique, called the ridge expansion osteotomy (REO), that allows the surgeon to widen the ridge in a routine office procedure was also introduced. This article provides additional details about the REO, including an analysis of the advantages of the REO over other methods of ridge expansion. Clinical cases are presented that show the suitability of the REO for anterior and posterior locations, and the effects of the REO technique on implant angulation and esthetics are discussed.