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Objectives: The aim of this matched prospective cohort study was to examine the microarchitecture of the augmented bone following a modified alveolar ridge splitting procedure and compare it to that of native bone. Methods: In the test group, patients underwent a modified ridge split osteotomy procedure to restore the width of the posterior segment of the mandible. Patients with sufficient bone width for dental implant placement in the posterior region of the mandible following 3-month-long spontaneous healing after tooth removal were included in the control group. In both study groups, bone biopsy samples were harvested and dental implants were placed. Histomorphometry and micro-CT analysis were performed. Results: Altogether, 15 patients were included in this study (7 patients in the test group, with 14 bone core biopsies harvested, and 8 patients in the control group, with 13 bone core biopsies harvested). Percentage bone volume (BV/TV) in the micro-CT analysis (22.088 ± 8.094% and 12.075 ± 4.009% for the test and control group, respectively) showed statistically significant differences between study groups. Conclusions: Based on histological and micro-CT analyses, the modified ridge splitting procedure with autologous bone block harvested from the retromolar area results in a dental implant recipient bone microarchitecture superior to that of the extraction sockets left to heal undisturbed for a 3-month-long healing period. [ABSTRACT FROM AUTHOR]