Implant site preparation with osteotomes: principles and clinical application.

The use of implant-supported restorations is a well-accepted and predictable treatment modality. Drilling has been the traditional method for cylindrical implant site preparation. This procedure, however, removes a considerable amount of bone. This article presents an alternative site preparation method--the use of osteotomes--which preserves, expands, and condenses alveolar bone. Indications, advantages, and the clinical procedure are presented, with extensive details on bone preservation, expansion, condensation, and sinus floor elevation. The learning objective of this article is to familiarize the reader with the principles of this alternative method and the clinical application of osteotomes.