The implant-prosthetic treatment in areas of high aesthetic value, although the elective approach, becomes especially critical when the bone volumes are not perfectly kept at their bucco-lingual and apico-coronal aspect. The evolution of the surgical regeneration techniques has allowed the anatomy of the receiving site to be corrected so that implants that are adequate in diameter and location can be inserted. Some of these procedures are complex and invasive requiring multiple phases. The Split-Crest through apical bone distraction (E.S.E.), used in this case report, allows, in one surgical act, the tridimensional restoration of the osseo-mucogingival complex. In addition it allows the correct axial implant positioning depending on the prosthetic projection of the supported element. With the emerging profile management of the abutment-crown complex the tissue morphology is conditioned shaping the gum profile on the natural elements.