The osteotome technique: Part 4--Future site development

Previous articles in the Compendium (February 1944, April 1944, and June 1944) described the use of osteotome hand instruments for maxillary implant surgery. The osteotome procedures that were introduced compressed soft maxillary bone, widened narrow ridge segments (ridge expansion osteotomy [REO] technique), and elevated the sinus floor for immediate implant insertion (osteotome sinus floor elevation [OSFE] and bone-added osteotome sinus floor elevation [BAOSFE] surgery). This article presents an improved method of creating sites with osteotomes under a low sinus when there is insufficient bone for immediate fixation of implants. In addition, a new means of intruding the ridge crest with larger osteotomes to create broader areas of sinus floor elevation, known as the future site development (FSD) procedure, is outlined. A comparison of FSD with current types of sinus floor surgery is detailed. The advantages of combining FSD with periodontal surgery, other regenerative procedures, and tooth extraction is presented. The author concludes that FSD surgery is a suitable means of altering the ridge to create implant sites for staged implant placement.