Use of Osteotomes for Sinus Augmentation at theTime of Implant Placement
You will receive 1 credit(s) of continuing education credit upon successful completion of this course. The purchase price of this course is $49.00


This course describes the osteotome technique for sinus augmentation at the time of implant placement and presents a short-term evaluation of 34 implants placed in 18 patients.

Learning Objectives:

Upon completion of this course, participants should be able to do the following:

  1. Discuss the rationale for sinus augmentation at the time of implant placement.
  2. Describe the technique of sinus augmentation using osteotomes.
  3. List the materials necessary for performing sinus augmentation with osteotomes.
  4. Discuss the advantages and limitations of osteotome sinus augmentation.


The loss of alveolar bone often hampers placement of endosseous dental implants. In the posterior maxilla, the maxillary sinus and less-dense bone present additional obstacles to successful implant placement. Existing methods of subantral augmentation require extensive surgical manipulation, often including a second surgical site for harvesting autogenous bone. The development of surgical osteotomes has facilitated the placement of implants in areas of minimal alveolar bone height in the posterior maxilla. This course describes the osteotome technique for sinus augmentation at the time of implant placement and presents a short-term evaluation of 34 implants placed in 18 patients.



  1. Introduction

  2. Materials and Methods

  3. Results

  4. Case Reports

  5. Summary


  1.  Atwood DA. Postextraction changes in the adult mandible as illustrated by microradiographs of mid-sagittal sections and serial cephalometric roentgenographs. J Prosthet Dent. 1963;13:810-815.
  2. Pietrokovski J, Massler M. Alveolar ridge resorption following tooth extraction. J Prosthet Dent. 1967;17:21-27.
  3. Pietrokovski J. The bony residual ridge in man. J Prosthet Dent. 1975;34:456-462.
  4. Misch CE. Treatment planning for edentulous maxillary posterior region. In Misch CE, ed. Contemporary Implant Dentistry. St. Louis, Mo: Mosby; 1993:241.
  5. Michael C, Barsoum W. Comparing ridge resorption with various surgical techniques in immediate dentures. J Prosthet Dent. 1976;35(2):142-155.
  6. Tallgren A, Lang BR, Walker GF, et al. Roentgen cephalometric analysis of ridge resorption and changes in jaw and occlusal relationships in immediate complete denture wearers. J Oral Rehabil. 1980;7:77-9. 
  7. Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: A mixed-longitudinal study covering 25 years. J Prosthet Dent. 1972;27(2):120-132.
  8. Swenson R. Complete Dentures. 2nd ed. St. Louis, Mo: Mosby; 1947:22.
  9. Linkow LI. Maxillary Implants: A Dynamic Approach to Oral Implantology. North Haven, Conn: Glarus Publishing;1977.
  10. Tatum OH. Lecture presented to Alabama Implant Study Group; 1977.
  11. Tatum OH. Maxillary and sinus implant reconstruction. Dent Clin North Am. 1986;30:207-229.
  12. Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg. 1980;38:613-616. 
  13. Smiler DG, Johnson PW, Lozada JL. Sinus lift grafts and endosseous implants: Treatment of the atrophic posterior maxilla. Dent Clin North Am. 1992;36(1):131-186. 
  14. Chanavaz M. Maxillary sinus: Anatomy, physiology, surgery and bone grafting related to implantology—eleven years of surgical experience (1979-1990). J Oral Surg. 1990;16:199-209. 
  15. Summers RB. The osteotome technique: Part 3—less invasive methods of elevating the sinus floor. Compend Contin Educ Dent. 1994;15(6):698-710. 
  16. Summers RB. The osteotome technique: Part 4—future site development. Compend Contin Educ Dent. 16(11):1090-1099. 
  17. Nishibori M, Betts NJ, Salama H, et al. Short-term healing of autogenous and allogeneic bone grafts after sinus augmentation: A report of two cases. J Periodontol. 1994;65(10):958-966.
  18. Wallace SS, Froum SJ, Tarnow DP. Histologic evaluation of sinus elevation procedure: A clinical report. Int J Periodontics Restorative Dent. 1996;16:47-51. 
  19. Moy PK, Lundgren S, Holmes R. Maxillary sinus augmentation: Histomorphometric analysis of graft materials for maxillary sinus floor augmentation. J Oral Maxillofac Surg. 1992;51:857-862.
  20. Wheeler SL, Holmes RE, Calhoun CJ. Six-year clinical and histologic study of sinus-lift grafts. Int J Oral Maxillofac Implants. 1996;11(1):26-34.
  21. Summers RB. A new concept in maxillary implant surgery: The osteotome technique. Compend Contin Educ Dent. 1994;15(2):152-162.
  22. Summers RB. The osteotome technique: Part 2—the ridge expansion osteotomy (REO) procedure. Compend Contin Educ Dent. 1994;15(4):422-436. 
  23. Saadoun AP, LeGall MG. Implant site preparation with osteotomes: Principles and clinical application. Pract Periodontics Aesthet Dent. 1996;8(5):453-463.
  24. Sutter F, Schroeder A, Buser DA. The new concept of ITI hollow-cylinder and hollow-screw implants: Part 1—engineering and design. Int J Oral Maxillofac Implants. 1988;3(3):161-172.
  25. Jaffin RA, Berman CI. The excessive loss of Brånemark fixtures in type IV bone: A five-year analysis. J Periodontol. 1991; 62(1):2-4.
  26. Olsson M, Friberg B, Nilson H, et al. MkII—a modified self-tapping Brånemark implant: 3-year results of a controlled prospective pilot study. Int J Oral Maxillofac Implants. 1995;10(1):15-22.
  27. Whittaker JM, James RA, Lozada JL. Histological response and clinical evaluation of heterograft and allograft materials in the elevation of the maxillary sinus for the preparation of endosteal dental implant sites. Simultaneous sinus elevation and root form implantation: An eight-month autopsy report. J Oral Implantol. 1989;15(2):141-144.
  28. GaRey DJ, Whittaker JM, James RA, et al. The histologic evaluation of the implant interface with heterograft and allograft materials: An eight-month autopsy report, part II. J Oral Implantol. 1991;17(4):404-408. 
  29. Wetzel AC, Stich H, Caffesse RG. Bone apposition onto oral implants in the sinus area filled with different grafting materials. A histological study in beagle dogs. Clin Oral Implants Res. 1995;6:155-163.
  30. Misch CE. Density of bone: Effect on treatment planning, surgical approach, and healing. In Misch CE, ed.: Contemporary Implant Dentistry. St. Louis, Mo: Mosby; 1993:480.
  31. Pohler OE. Swiss screw: Concept and experimental work. J Oral Implantol. 1986;12:338-348. 
  32. Wilke HJ, Claes L, Steinemann S. The influence of various titanium surfaces on the interface shear strength between implants and bone. Advances in Biomaterials. 1990;9:309-314.
  33. Buser D, Schenck RK, Steinemann S, et al. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res. 1991;25:889-902.

n. A wedge-like instrument used for cutting or marking bone, often called a chisel; used with a mallet. Varieties: Curved or straight; no handle

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