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Osteotome
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An osteotome is an instrument used for cutting or preparing bone.[1] Osteotomes are similar to a chisel but bevelled on both sides.[2] They are used today in plastic surgery, orthopedic surgery and dental implantation.[3] In dentistry the term is applied to instruments that prepare the implant site by compacting and displacing bone rather than by cutting it away, a usage that differs from the cutting instruments of orthopaedic surgery.[3]
The chain osteotome, originally referred to simply as the osteotome, was invented by the German physician Bernhard Heine in 1830.[4][5] This device is essentially a small chainsaw.[6][7]
Use in dental implantation
In implant dentistry the osteotome is not primarily a cutting instrument. Instruments described as osteotomes in this field prepare the implant site by compacting and laterally displacing bone rather than by removing it. The approach was introduced by Robert B. Summers in 1994 as the osteotome technique.[3]
A graduated set of tapered or concave-tipped osteotomes of increasing diameter is advanced into the soft trabecular bone of the posterior maxilla by tapping with a mallet, so that bone is compressed against the walls of the site rather than cut away. Because bone is conserved, the technique avoids the heat generated by rotary drilling, increases the density of the bone surrounding the implant and can improve primary stability.[3] The same instruments are also used to widen a narrow alveolar ridge before implant placement, a procedure referred to as ridge expansion or bone spreading.[8]
Osteotomes are further used for transcrestal, or internal, sinus floor elevation, commonly abbreviated OSFE. The instrument is used to infracture the floor of the maxillary sinus through the implant site and to raise the overlying sinus membrane, also known as the Schneiderian membrane, without opening a lateral window in the sinus wall. This allows longer implants to be placed where the height of the residual bone is limited, and is less invasive than the lateral window approach.[9][8]
More recently, rotary instruments used in osseodensification have been proposed as an alternative to hand-driven osteotomes for the same purposes.[8]
See also
References
- ↑ Gould, George Milbry; Scott, Richard John Ernst (1919). The Practitioner's Medical Dictionary: Containing All the Words and Phrases Generally Used in Medicine and the Allied Sciences, with Their Proper Pronunciation, Derivation, and Definition. P. Blakiston's. pp. 639–. Retrieved 2 December 2012.
- ↑ Swiontkowski, Marc F. (2012-09-10). Manual of Orthopaedics. Lippincott Williams & Wilkins. pp. 209–. ISBN 9781451115925. Retrieved 2 December 2012.
- 1 2 3 4 Summers, Robert B. (1994). "A new concept in maxillary implant surgery: the osteotome technique" (PDF). Compendium. 15 (2). Newtown, Pa.: 152–154. PMID 8055503. Archived from the original (PDF) on 2014-05-17. Retrieved 2012-12-02.
- ↑ The Lancet London: A Journal of British and Foreign Medicine, Surgery, Obstetrics, Physiology, Chemistry, Pharmacology, Public Health and News. Elsevier. 1835. pp. 127–.
- ↑ Seufert, Wolf D. (1980). "The Chain Osteotome by Heine". Journal of the History of Medicine and Allied Sciences. XXXV (4): 454–459. doi:10.1093/jhmas/XXXV.4.454. ISSN 0022-5045. PMID 7005321.
- ↑ Peltier, Leonard F. (1993). Orthopedics: History and Iconography. Norman Publishing. pp. 37–. ISBN 9780930405472. Retrieved 2 December 2012.
- ↑ Tillmanns, Hermann (1895). The principles of surgery and surgical pathology: general rules governing operations and the application of dressings. D. Appleton and company. pp. 84–. Retrieved 2 December 2012.
- 1 2 3 Cobo-Vázquez, Carlos Manuel; García-Rodríguez, Sonia; Colmenares-Otero, María Eugenia; Sáez-Alcaide, Luis Miguel; Cortés-Bretón-Brinkmann, Jorge; Madrigal Martínez-Pereda, Cristina; Meniz-García, Cristina (2025). "Clinical and radiographic evaluation for two crestal sinus lift techniques: osteotome versus osseodensification. A systematic review and meta-analysis". International Journal of Implant Dentistry. 11 (1). doi:10.1186/s40729-025-00615-9.
- ↑ Summers, Robert B. (1994). "The osteotome technique: Part 3—Less invasive methods of elevating the sinus floor". Compendium. 15 (6): 698, 700, 702–704. PMID 7994726.
