A Simple, Custom-Made Osteotome for Sinus Floor Elevation

Figure 1 . Schematic photograph of the custom-made sinus lift osteotome. Figure 2. The osteotome comprises a body (B), an intermediate connecting portion (I) and a head (H) that has a circular cross section. The diameter of the working tip is slightly smaller than the largest diameter of the working drill that can normally be used in the implant bed.

Figure 3 . Intra-operative radiograph of the maxillary right first molar showing a residual bone height of 7 mm. Figure 4. Slow and gentle tapping of the osteotome performed with a mallet. The surgery was performed at a rural clinic maintained by the institution. Figure 5. The vertical condensation of the graft with the osteotome resulted in a lift of about 4 mm. Figure 6. Radiographic evidence of well-contained graft material apical to the 5 × 10.5 mm implant. Figure 7. Six-month postoperative radiograph. The radiopacity of the elevated space is almost continuous with that of the original ridge.

Figure 8 . Radiograph of the maxillary right molar region. A straight explorer could be pushed into the bone without encountering any resistance. Figure 9. Gentle tapping of the osteotome with a mallet to the proper depth. The surgery was performed in an outreach clinic maintained by the institution. Figure 10. A lift of about 4 mm was obtained by using the osteotome. Figure 11. Postsurgical radiograph: a 4.5 × 10.5 mm implant was placed. Figure 12. Six-month postoperative radiograph showing elevated sinus level and maturing bone graft.