Laminectomy is a commonly performed surgery to decompress the spinal canal to relieve spinal canal stenosis secondary to a variety of etiologies such as degenerative spinal changes, fractures, tumors, vascular lesions, and infections. Advances in technologies have allowed for more precise osteotomies and offer more protection to nearby structures; however, these technologies may not always be available at some facilities. To the best of the authors\' knowledge, we describe an innovative technique to perform laminectomy using a handheld osteotome, which is widely available and at low cost. Our experience with cadavers and a case study shows that the technique appears to be safe and effective and may have the potential to reduce the procedure length of a laminectomy.

UNASSIGNED: Olecranon osteotomy is employed for the fixation of intraarticular distal humeral fractures. We conducted a prospective, randomised study comparing Chevron\'s osteotomy with olecranon osteotomy by a Gigli saw for exposure of the intraarticular distal humerus in terms of functional outcome and intra-operative ease of the surgery.
UNASSIGNED: Thirty patients with skeletally mature AO/OTA type 13- B and 13-C distal humerus fractures were randomly allocated to Chevron\'s or Gigli saw groups. Each group consisted of a total of 15 patients. Both the groups were assessed on post-operative parameters including arm, shoulder or hand pain, ability to perform certain routine activities, tingling sensations and pain while sleeping.
UNASSIGNED: In the Gigli saw group, 12 patients had no gross limitation of activity and 13 were able to perform moderate activities with ease. Similar results were observed in the Chevron\'s group. The mean difference between the two groups in Oxford Score was 0.60, within the 95% confidence interval and in line with QuickDASH-11 Score.
UNASSIGNED: Chevron\'s technique offers stability and better healing, providing a larger surface area for bone union. However, it is challenging and time-consuming. Also, literature suggests that the Gigli saw has multiple benefits, saves time and effort, and heals by switching blood supply from centrifugal to centripetal post-operatively. Our study suggests that both Chevron\'s technique and the use of the Gigli saw are effective in distal humeral intra-articular fractures as assessed by multiple parameters. Hence both techniques can be equally used depending on the surgeon\'s preference.

UNASSIGNED: Trans-crestal sinus lift procedures are well established.
UNASSIGNED: to retrospectively analyse the efficacy of a flapless trans-crestal maxillary sinus floor elevation and simultaneous dental implant placement based on the Localised Management of Sinus Floor (LMSF) technique suitable for cases with sufficient width of keratinized tissue and of crestal bone but insufficient vertical dimensions of the bone below the sinus.
UNASSIGNED: 71 sinus elevations with simultaneous implant placement were performed on 52 consecutive patients. Following an initial pilot bur transmucosal perforation, the Magnetic Mallet was used with progressively larger osteotomes. The mallet osteotomes are initially directed palatally, towards the cortex of the medial wall of the sinus, below the palato-nasal recess (PNR) and then redirected in a more vertical direction to create the final osteotomy for implant placement.
UNASSIGNED: No significant complications were reported in the post-operative phase. The cumulative success rate during the observation period was 95%. All successful implants were successfully loaded with metal-ceramic or monolithic zirconia crowns and bridges and remained in function during the observation period.
UNASSIGNED: Flapless Localised Management of Sinus Floor (LMSF) is a safe and effective surgical technique with minimal risks and with the advantage of low morbidity. Also, only native bone is used for augmentation and there is no need for additional grafting.

Implants inserted in the posterior maxilla frequently need additional surgery for successful bone augmentation. One of the most common procedures for this is transalveolar sinus floor elevation. There are different protocols for this procedure, and there is controversy over the simultaneous application of grafting material upon elevating. In this prospective randomized clinical study in humans, a total of 49 transalveolar sinus floor elevations were performed in 49 different patients, divided into a control group (without graft, 25 patients) and a test group (with graft, 24 patients). The analyzed variables were obtained through digital orthopantomography on day 0 (day of surgery) and 18 months after surgery. These measurements showed a tendency towards greater vertical bone gain in the test group, but this was not statistically significant. Therefore, considering that sinus elevation and implant placement without the application of grafts is a successful treatment with fewer complications, a critical assessment of the need for these biomaterials is necessary.

BACKGROUND: First tarsometatarsal (TMT) joint fusion is effective for treatment of arthritis and some first ray deformities. To prepare the articular surfaces, cartilage should be carefully but completely denuded. Inadequate preparation may result in non-union, while excessive preparation may cause ray shortening and consequential transfer metatarsalgia. Preparation can be performed with an osteotome or a saw. The purpose of this study was to investigate whether utilization of an osteotome or saw would minimize shortening of the first ray in TMT arthrodesis.
METHODS: Ten fresh-frozen cadaver specimens were randomly assigned to undergo joint preparation using either an osteotome (n=5) or saw (n=5). Sample size was determined by cadaver availability. Fusion was performed using a cross-screw construct through the dorsal aspect of the proximal phalanx and the medial cuneiform. Pre- and post-operative X-rays were taken with a radiopaque ruler in the field, and changes in length in the first metatarsal and first cuneiform were compared between osteotome and sawblade groups.
RESULTS: The average change in metatarsal length was significantly smaller in the osteotome group (1.6mm) as compared to the saw group (4.4mm) (p=0.031). The average percent change in metatarsal length was also significantly smaller in the osteotome group (3.0%) compared to the saw group (8.4%) (p=0.025). There was no significant difference between the two groups with respect to change in cuneiform length. The osteotome group demonstrated a significantly smaller average measured change (3.0mm vs. 6.9mm, p=0.001) and percent change (4.1% vs. 9.3%, p<0.001) in total length (cuneiform plus metatarsal) in comparison to the saw group.
CONCLUSIONS: In first TMT fusion, joint preparation with an osteotome may prevent over-shortening of the first ray in comparison to preparation with a saw.

BACKGROUND: Currently, dental treatments with better aesthetic results and less treatment time is more acceptable by the patients. Inadequate amount of bone for implant placement at functionally and aesthetically most appropriate position is a common problem.
OBJECTIVE: To assess the effect of ridge expansion on implant stability in narrow partially edentulous ridges and to evaluate clinically and radiographically the success of dental implants, placed immediately following ridge expansion procedure.
METHODS: Ten participants (nine males, one female, average age - 28 years) with partial edentulism associated with narrow atrophic alveolar ridges with adequate height and willing to participate in the study were included. The ridge expansion was performed using osteotomes and simultaneous implant placement was done. A total of 10 implants were placed. Stability, achieved ridge width and radiographic crestal bone loss were assessed three months post-operatively.
RESULTS: Three months follow-up revealed stable implants both clinically and radiographically. All 10 implants were surrounded by adequate amount of bone required for successful functional rehabilitation.
CONCLUSIONS: The study reveals that the technique of ridge expansion using osteotomes is successful in horizontal expansion, in cases of atrophic alveolar ridges thus, eliminating the need for more complex treatment as well as reduces the rehabilitation time along with improving the quality of bone support.

It may be difficult to achieve primary stability in the posterior maxilla because of poor quality and quantity of bone. Studies have shown that the osteotome technique immediately increases bone density thereby increasing primary stability. An in vitro study was conducted to compare the stability achieved by the osteotome and conventional drilling techniques in low density bone. Forty endosseous implant fixtures (n = 40) were inserted in a solid rigid polyurethane block simulating low density (D3) bone. The implants were divided into 4 groups to test 2 variables: (1) implant length (10 mm or 13 mm) and (2) preparation of osteotomy (conventional drilling or osteotome technique). Insertion torque (IT) and resonance frequency analysis (RFA) were measured for each implant. Statistical analysis using one-way ANOVA and Tukey post hoc test was done to study IT and RFA data of the 4 groups. Pearson Correlation test was used to determine the correlation between IT and RFA values of the implants. The IT and RFA values were statistically significant higher using the osteotome technique as compared to conventional drilling (P < 0.0001). Statistically significant higher values were also found for IT and RFA of 13 mm implants as compared to 10 mm implants. A significant correlation was found between insertion torque and RFA values in all 4 groups (r = 0.86, P < 0.0001). The conclusion was that the osteotome technique significantly increased primary stability.

OBJECTIVE: The aim of this clinical study was to compare electrical versus hand mallet in osteotome-assisted surgery for maxillary bone condensing in immediately loaded implant procedure.
METHODS: Edentulous patients in maxillary premolar and molar regions with type III or IV bone were enrolled in this prospective clinical study. The patients were randomly divided in two groups: in the test group (magnetic mallet group [MMG]), the implant site was prepared with osteotomes pushed by electrical mallet, while in the control group (hand mallet group [HMG]), the implant site was performed with osteotomes pressed by hand mallet. Implants were immediately loaded. Intraoral digital radiographic measurements were reported at 6, 12, and 24 months.
RESULTS: Fifty patients were enrolled in the study. Twenty-five patients were included in MMG and 25 patients in the HMG. One hundred thirty-eight dental implants were placed. In 12 cases, six in MMG and six in HMG, sinus elevation was performed. After 24-month follow-up, a survival rate of 94.93% was reported (MMG and HMG reported a survival rate of 97.10 and 92.75%, respectively, not statistically significant [P > .05]). In control group, two patients claimed benign paroxysmal positional vertigo following the use of osteotomes with hand hammer. Marginal bone levels remained stable over time for both groups, and no statistically significant differences were found. After 12 months, the bone height increased in both groups and, at 24 months, was stable. Statistical analysis reported no significant differences between test and control groups.
CONCLUSIONS: These results demonstrated a stable marginal bone levels over time and a significant increase in bone height between 6 and 12 months in osteotome technique. The use of electrical mallet provided some essential clinical advantages for the patients during surgical procedure in comparison with hand mallet.

OBJECTIVE: The aim of this study was to compare the use of hand mallet versus electrical mallet (magnetic mallet, Meta-Ergonomica, Turbigo, Milan, Italy) in osteotome-assisted surgery for condensing bone procedure in edentulous molar and premolar maxillary regions.
METHODS: Patients edentulous in maxillary premolar and molar regions with type 3 or 4 bone were enrolled in this prospective clinical study. The patients were randomly divided in two groups: in the test group, the implant site was prepared with osteotomes pushed by magnetic mallet, while in the control group, the implant site was performed with osteotomes pressed by hand mallet. Intraoral digital radiographic measurements were reported at 6, 12, and 24 months.
RESULTS: Thirty-six patients were enrolled in the study. Eighteen patients (21 women and 15 men) were included in the test group and 18 patients in the control group. The mean patient age was 56.1 years (range 41-71 years). Fifty dental implants were placed. In 10 cases, five in control and five in test group, sinus elevation was performed. After 24 months follow-up, a survival rate of 96.0% was reported. In the control group, two patients claimed benign paroxysmal positional vertigo following the use of osteotomes with hand hammer. Marginal bone levels remained stable over time for both groups, and not statistically significant differences were found. After 12 months, the bone height incremented in both groups and, at 24 months, was stable. Statistical analysis reported not statistically significant differences between test and control group.
CONCLUSIONS: These results demonstrated a stable marginal bone levels over time and a significant increase in bone height between 6 and 12 months in osteotome technique (not sinus elevation). The use of magnetic mallet provided some essential clinical advantages during surgical procedure in comparison with hand mallet.