The case report describes the distraction osteogenesis of a small bone fragment supporting a maxillary central incisor that had become ankylosed and infraoccluded after trauma. After initial orthodontic treatment, surgery was performed, entailing a trapezoidal osteotomy with minimal periosteal elevation through a horizontal incision. On this occasion, a device was applied, anchored to the tooth, and activated by a micrometer screw. On completion of distraction, the fragment was retained for 5 months. The ankylosed tooth was then removed, and an implant was inserted and provided with an immediate provisional prosthesis without occlusal loading. Five months later, a definitive prosthesis with occlusal loading was applied and is still in place 1 year later without any problems.