Purpose: Anterior maxillary alveolar vertical distractions were followed for a 5-year period of time. Materials and Methods: A total of 30 vertical distractions were done in 28 patients. Two patients had both anterior maxilla and anterior mandibular distractions for a total of 30 distractions. Two distraction techniques were used: an implant device (3i) and an orthodontic screw device (Osteomed) for orthodontic attachment. Both devices enabled some horizontal as well as vertical movement. The average net vertical distraction was 6.5 mm, but the average anterior horizontal movement was less than 2 mm. Results: Eighty-four implants were placed, but 8 implants failed to integrate. Discussion: All failed implants had been placed in poor quality bone that needed bone grafting. The most common restoration was a fixed prosthesis supported by implants; the longest follow-up post loading was 4.4 years. Conclusion: This clinical study gives additional evidence in favor of the stability and utility of vertical distraction procedures in the maxillary esthetic alveolar zone. Keywords: alveolar distraction osteogenesis, alveolar orthognathic form, alveolar orthognathic position, alveolar projection, avascular necrosis, crestal bone, distraction screws, horizontal distraction, implant esthetics, LeFort I osteotomy, osseointegration, over