Alternating osteotome with variable conicity technique: clinical applications in upper jaw implant surgery

Bone augmentation procedures routinely are required before dental implant placement. Several techniques for this procedure may be considered, such as guided bone regeneration, bone block grafting, and ridge splitting for bone expansion. The osteotome technique presents many advantages compared with traditionally drilled burs, especially on low-density bone. Osteotomes compact and expand the alveolar ridge in atrophic maxillary bones in which rigid corticalization seems to be better conserved by osteotomic dislocation. This article describes a method of manual osteotomic preparation of implant sites with three clinical applications: alveolar anatomic remodelling of an edentulous jaw, alveolar compacting and remodelling if the immediate postextractive site, and slight lift of the maxillary sinus.