A young patient complained of missing inferior second premolars. Clinical and cephalometric parameters suggested the indication for a prosthetic solution, opening the spaces between first premolars and molars, aiming to correct occlusal relationships. Space closure was thus excluded. After full arch alignment a selective conservative channel-like wedge shaped osteotomy, distal to the second molars, was performed, applying a piezo-microsurgery technique, which uses fine inserts (0.5-0.7 mm) and ultrasound. The method allows for good patient compliance, improved rapid healing, and no secondary adverse effects. Both second and first molars can then be easily and rapidly distalized with a bodily movement, avoiding distal tipping. After space opening implants could be applied and the occlusion finalized. Though further tests will be needed, the method appears a valid improvement to conventional methods, facilitating distalization in selected cases and possibly shortening treatment time.