Inclusion Criteria:  English speaking At least 18 years old Must be a patient of the UAB Dental School Able to read and understand informed consent document Need for implants to replace missing tooth or teeth in at least one quadrant of the mouth. Insufficient alveolar ridge width for endosseous implant placement defined as 5mm or less as determined by bone sounding and cone beam computed tomography (CBCT) scan.  Exclusion Criteria:  Non-English speaking Less than 18 years old Smokers/tobacco users (>10 cigarettes/day) Patients with systemic pathologies or conditions contraindicating oral surgical procedures or adversely affecting wound healing Patient is a poor compliance risk (i.e., poor oral hygiene, history of alcohol or drug abuse) Vertical loss of bone at edentulous ridge.