Aesthetic Enhancement of Anterior Dental Implants With the Use of Tapered Osteotomes and Soft Tissue Manipulation

Abstract

An adequate bone base is usually a prerequisite for functionally and aesthetically optimal reconstruction of the soft tissue architecture around a dental implant. In patients with sufficient bone height but insufficient bone width as a result of tooth loss, a jaw enlargement technique with osteotomes combined with soft tissue manipulation may be utilized to facilitate proper implant placement while concomitantly optimizing the aesthetics of the final implant prosthesis. The learning objective of this article is to familiarize the reader with the principles of ridge expansion with tapered osteotomes combined with periodontal plastic soft tissue surgery to aid in proper implant placement and enhance the aesthetic result of the final prosthesis.

Comparison of Crestal Bone Loss and Implant Stability Among the Implants Placed With Conventional Procedure and Using Osteotome Technique: A Clinical Study

“…[17][18][19][20] The use of the osteotome technique has been investigated in clinical studies with emphasis given on the survival rate of the implants. [33][34][35][36][37] However, there is a lack of clinical studies that compare the osteotome technique with the conventional technique of implant placement in the same patient. Therefore, the aim of this clinical study was to evaluate the crestal bone loss and biomechanical outcome of implant placement in condensed bone.…”

Bone Manipulation Techniques

“…Through the serial use of graduated chisel-like cylindrical or tapered instruments ridges can be slowly expanded to increase their width. 20 The objective of this technique is to maintain the existing soft bone by pushing the buccal bony plates of the residul ridge laterally with minimal trauma while simultaneously developing an accurately shaped osteotomy. This technique takes advantage of the softer bone quality found in type III and type IV maxillary bone by relocating the alveolar bone rather than losing the precious bone by drilling.…”

A Novel Technique for Osteotome Internal Sinus Lifts With Simultaneous Placement of Tapered Implants to Improve Primary Stability

“…9 Furthermore, osteotomes have been successfully used to (1) aid in sinus membrane elevation via the crestal approach, (2) expand narrow ridges, (3) aid in immediate implant placement, and (4) improve implant stability. [10][11][12][13] Another important parameter that can influence implant stability and that has been extensively investigated is implant geometry. Because of the minimal amount of cortical bone in the posterior maxilla (Type III or Type IV bone quality), the tapered implant design is preferred over a parallel design.…”