Purpose: The current study was conducted to evaluate, clinically and radiographically, the results of defective ridge augmentation by external oblique ridge graft with or without the use of computer-generated surgical guide. Patients and methods: Twelve patients with alveolar ridges defect were included in this study. The patients were divided into 2 groups: Group A; The alveolar ridges defect augmentation from external oblique ridge graft using Khoury technique with computer- designed generated surgical guides. Group B; The alveolar ridges defect augmentation from external oblique
ridge graft using traditional Khoury technique. Clinical and radiographic follow up was performed for 6 months. Treatment changes were evaluated for each group and a comparison was done between the 2 groups. Data were analyzed using paired t-test for each group and student t- test to compare between the two groups. Results: There was a significant increase in bucco-lingual/palatal ridge dimensions between the two studied groups. While the minimal bone distances to the nerve differ significantly (p < 0.05), the computer guided group had greater amount of bone remaining around the nerve than non-guided group. Conclusion: Computer assisted surgical guides allow for accurate precise osteotomies providing safe and quick surgery that reflects positively on the postoperative clinical outcomes.