This article presents a modified approach to the method of intercortical osteotomy and splitting of the alveolar ridge for use when the classical approach does not solve the problem of atrophy. The standard protocol for osteotomy with alveolar ridge splitting is not universal for all clinical situations. We operated on 33 patients using five modifications for splitting the alveolar ridge: lingual, vestibular and lingual, mesial, rotation of the bone block by 180°, and lingual with displacement of the osteotomy line. In all cases, the alveolar ridge width reached 7.1±0.7 mm, sufficient for installation of dental implants with a regular or wide platform (3.75–5.0 mm), and only 6.1 % of implants failed. Based on the biological principles of alveolar bone regeneration, the indications for the use of intercortical osteotomy and splitting of the alveolar ridge have been expanded for use in various clinical situations. © Group of authors, 2021