implants - international magazine of oral implantology

I overview manually or inserted in the alveolar bone with the aid of gentle taps on the proximal end of the working element because the jaw bone is relatively soft in some areas (D3/D4 bone, ac- cordingtoC.E.Misch).Theimplantaxiscanbe maintained or corrected. Larger hollow os- teotomes are available for bigger implant diame- ters. Further additional compression of the sur- rounding bone can be done with a full thickness os- teotome. On the one hand, the cutting edge helps to keep andfixtheosteotomeinthedesiredposition.Onthe other hand, it facilitates pushing or driving the os- teotome into the jaw bone. When inserting the os- teotome into the alveolar bone, the plates are dis- placed outwards. As a result, the surrounding bone is condensed. Abonecorepenetratesintothelumenofthehollow cylinder.Uponremoval,thisbonecylinderinsidethe cutting element of the osteotome usually remains in the instrument and can then be used as an autol- ogous bone graft. As there is no rotation of the hol- low cylinder while seated and inserted into the jaw bone, no injury to the soft tissue or jaw bone can arise. Inaddition,thecuttingedgeoftheinstrumentis bevelled to the distal end of its outside wall. In this way, a three dimensional chisel or wedge-like cir- cumferential distal working end results. This facili- tates the introduction of the osteotome operating element into the jaw bone. Markers(Fig.6a)arearrangedaroundtheoutside of the operating element, which show the distance to the distal end of the working element on a scale. Thus, the user is provided with information of how far the operating element of the hollow osteotome has already penetrated into the jaw bone. The wall thickness is significantly lower than in theknowntrephinedrillsbecauseofthenon-rotat- ingapplication.Reducedornolossofbonematerial is achieved and a bone cylinder of a larger diameter can be removed by using the osteotome. The wall thickness of the hollow cylinder instrument is less than 0.3 mm (Fig. 6b). This version of the osteotome is designed as a two-pieceentity,sothatthehandlecanalsobeused for other osteotomes. This means that the number of instruments (Fig. 9) can be kept relatively small since only the operating element has to be ex- changed. 26 I implants1_2013 Fig. 9a Fig. 10c Fig. 12Fig. 11 Fig. 13a Fig. 13b Fig. 13c Fig. 14a Fig. 14b Fig. 14c Fig. 15 Fig. 9_Osteotome set (Design H. Zepf). Figs. 10a-c_Bone harvesting via hollow osteotome. Fig. 11_Transmucosal punching and simultaneous preparation of a bone cavity for dental implantation. Figs. 12_Application of hollow osteotomes in navigated implantology in order to avoid overheating by drilling with reduced irrigation. Figs. 13a-c_Preparation and transformation of an extraction site for the removal of autologous bone and simultaneous immediate implant placement. Fig. 14a-c_Application of the indirect sinus lift technique by hollow osteotome: a) extraction of the bone core; b) pushing in the cortical plate; c) augmentation and simultaneous implantation. Fig. 15_Final X-ray. Fig. 10a Fig. 10b