Osseous distraction: alternative to grafting?

It has been done for years and years now. There are several companies that manufacture distracting devices and promote several different techniques. The answer to your question is still NO. That is why with all of its shortcomings, problems and limitations, grafting is still king. Just saying....

Most distraction cases end up needing grafting as well because the increase height but not width. In addition it is extremely difficult to control the direction of the distraction so grafting is often needed to compensate for "the bone's in the wrong place" .

Distraction is a very sensitive technic, it is more applicable on large bones or on retrognathic cases. I have done some for increasing ridge height With good results, but with a lot of aggravation to the patient. The answer is no, keep doing bone grafting. Maybe one day a more practical design will be available

I agree with all of the above comments. DO is very Technic sensitive, best suited for bigger segments, and seasoned surgeons. Secondary grafting and complications with DO are not much different than with block grafting. Try GBR with a Ti PTFE membrane being sure to fixate it with pins or Profix screws, That Technic is much more forgiving than block grafting or DO. If you go that route, watch the patient regularly for membrane exposure and get it out as soon as you see it exposed.