Bone Expander Drills vs. Osteotomes: Pros and Cons?

I have read about bone expander drills as an alternative to osteotomes and I’m wondering what the pros and cons of each set of instruments is? Are there specific indications where one would use the bone expander drills as opposed to the osteotomes? What would be better to start with in my practice, osteotomes or bone expander drills?

5 thoughts on “Bone Expander Drills vs. Osteotomes: Pros and Cons?

  1. Carlos Boudet, DDS says:

    Rotary bone expanders are great to have.
    You can leave them in place and take radiographs for length and angle determination without the need to tie a string like a direction verifier pin.
    You also eliminate the chance of dizziness or tinnitus from malleting on the osteotomes.
    It is always useful to have both and the osteotomes come in handy when doing the inal raising of the sinus floor and membrane in an internal lift.
    Borrow both kits and try each to see what you like and what technique works best in your hands.
    Good luck!

  2. Faisal Moeen says:

    I think bone expanders are great to have handy. Lots of control. When the bone is soft, they work well. Cant use them in the denser mandibular bone. Though, bone expansion takes much more time as compared to regular drilling and grinding out valuable bone. For me, ostetomes are used just for a few lighter taps to lift the sinus membrane through a crestal approach, right at the end. Like Dr. Carlos says, its good to have both of them around. The concept of compressing bone eventually leading to a high bone to implant contact area and saving bone in the process is a welcome. By the way, some expander screws have a concave tip which can lift the sinus membrane as well. Just make sure you match the sizes with the implants diamater, dont want too much insertion torgue fearing compression necrosis. Lastly, do ask about the number of times some of the thinner expanders can be used, dont want them to break from the neck when theyre submerged all they way in.

    • dr a says:

      thanku for the guidance.. pls let me know what can be the maximum insertion torque while using expanders…and which kit is providing a concave tip for sinus lift. r oesteotomes helpful in denser mandibular bone.

  3. WJ Starck DDS says:

    I prefer bone compression screws to expanders that one uses a mallet with as I have better control with compression screws. I have had buccal cortical plates partially or completely fracture away even in the maxilla, particularly in post menopausal women. My experience with malleted expanders is that they are pretty much useless in the mandible for the same reason…


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