The push osteotome: An alternative technique to preserve periodontal health in segmental Le Fort osteotomies: Technique and retrospective review

Abstract

o r d O s s i r s a a s a a I t u t d s t c o p t s p d t i significant consideration when performing interental osteotomies for segmental Le Fort I surgery is he effect of interdental osteotomy on the adjacent eriodontium. The concern is significant enough to arrant numerous studies to investigate the effect f interdental osteotomies on the periodontium durng segmental maxillary surgery. These studies have hown that interdental maxillary osteotomies perormed with rotary instruments may cause minor, but linically insignificant complications. The greatest limiting factor to interdental osteotoies using a rotary handpiece is the available bone etween roots adjacent to the planned osteotomy. he closer the adjacent roots are to an osteotomy, ragmatic sense would presume the greater the poential risk to the overlying periodontium. An alternaive device to traditional rotary instruments is the ush osteotome. The push osteotome is a modified igid, sharp, and extremely thin straight osteotome ith a large handle used manually to accomplish the nterdental osteotomies (Figs 1-4). Gripped in the alm of the hand, the push osteotome takes advanage of the viscoelastic property of bone to be comressed and manipulated even in cases with minimal vailable bone between adjacent tooth roots. This llows for greater tactile sensation and manual control ompared with rotary instruments when performing nterdental osteotomies. In addition, unlike rotary nstruments, the push osteotome generates no heat, hich can be detrimental to bone healing and/or