1. Tatum Bone Expansion Illustrations

2. Indication for Bone Expansion
Bone expansion techniques for dental implant placement were developed by Dr. Hilt Tatum in and are proven to be an efficient alternative to block and particulate grafting for patients who have adequate bone height but insufficient width to allow implant placement.

3. Bone Expansion Advantages
Cost effective
Reduces treatment time
Conserves precious bone cells
Eliminates difficult soft tissue closures
Restores labial contours

5. The frontal view of the edentulous segment of the maxillae demonstrates bone of adequate height and unknown width

7. The sagittal view of the edentulous segment of the maxillae demonstrates bone of inadequate thickness to allow conventional rotary cutting instruments to be used

9. Bone Expansion for the Maxillary Anterior Segment
The median palatine suture is a factor
Implants may be placed in the central incisor positions only at the initial surgery
Implants may be added to the lateral incisor positions 6wks following the initial placements

10. Aggressive bone expansion in an attempt to place adjacent implants in thin ridges will likely result in failure due to labial plate fracture

12. Implants are generally allowed to heal for 6 months in the maxillae and 4 months in the mandible prior to loading when utilizing bone expansion techniques

13. Sagittal View Single stage surgery Plateau or fins in bone
Grit-blasted surface may be in bone or soft tissue
Polished collar surface transmucosal

15. Illustrated Prosthetic Results
Conventional crown and bridge methods
Normal gingival contours
Normal occlusal relationships

18. Restored “D” elliptical implant
Normal gingival contour
Normal tooth anatomy
Maximum bone-implant surface area

19. The following diagrams and text describe basic bone expansion technique. Contact Tatum Surgical @ for educational workshops with hands on training

21. Bone Expansion Technique
Atrophic ridges as thin as 1mm at the labio-palatal crest may be expanded
A #11 scalpel blade is utilized to bisect the crestal bone

23. Bone entry with a scalpel
Carefully done to bisect the labial and palatal bone
The cortical bone must be penetrated to gain access to the interstitial bone

25. Bone expansion scapel technique
Follow the long axis of the bone to further penetrate and gain access to the medullary bone
These are gentle procedures done with controlled force

27. Scalpel removal from bone
Always rotate the scalpel mesial-distal with a gentle removing force
Never rotate the scalpel labio-palatal

28. Bone expansion access
A high-speed handpiece using a thin tapered diamond may be used following scalpel access to the medullary bone if it is hard and cortical in nature

30. Bone expansion instruments
The smallest dimension bone expander is inserted in the osteotomy
It is extremely important to expand the bone in the correct vertical axis

32. Prevent labial plate bone fracture
Palatal bone is not plastic and does not expand
Carefully brace the labial bone with finger-thumb pressure as the expansion instruments move the bone labially and open the osteotomy

39. Expansion instrument removal
Always remember to remove bone expansion instruments with a gentle, mesial-distal controlled action.
Never apply a labio-palatal removal action

42. Final size bone socket former
The osteotomy expansion is completed to depth with a bone socket former sized exactly as the implant to be inserted

43. Osteotomy depth measurement
Each instrument used for bone expansion has depth markings to indicate the exact implant length and location of the grit blasted collar

45. Bone expansion implant seating
Utilize the provided seating instrument
Gently drive the implant into the full depth of the expanded osteotomy

47. Sagittal view of Osteogen barrier
Slowly resorbable Osteogen is mixed with the patient’s blood to provide a barrier against epithelial migration into the osteotomy

49. Frontal-crestal view of “D” implant
View of completed surgery of elliptical implant place with bone expansion osteotomy.
Osteogen mixed with the patient’s blood is utilized as a barrier to prevent epithelial migration during initial healing

51. Sagittal view healed “D” implant
Single stage transmucosal
Plateau fins must be in bone
Grit-blasted surface relationship to bone height is determined by the thickness of the soft tissue

53. Post guide try-in
Post guides of 0,10,20,30 degrees are available in the surgery kit to pre-determine abutment post selection
Enter this information in the record at the time of surgery

55. Evaluate the opposing dentition
The implant position must allow the restored implant to have a non-traumatic occlusal relationship with the opposing teeth or prosthesis

57. Abutment post cementation
Read and understand the instruction manual on this website for cementation of the unique Tatum Unipost

59. Abutment post preparation
Gross reduction of the abutment post may be done using the post holder tool outside of the mouth
Final preparation and paralleling is done following cementation of the abutment post

61. Preparation requirements
The margin of the preparation Must extend onto the body of the implant
A small anti-rotational grove is extended onto the body of the implant
Margin placement is determined by the soft tissue contour and the planned emergence profile of the final restoration

63. Abutment selection & preparation
Prepare abutments to allow normal contour for anatomically correct prosthetics
Prepare abutments to allow proper material dimensions for strength and longevity of restorations

64. Sagittal view of restored implant
Physiologic contour
Normal emergence profile
Maintainable bone-circumferential soft tissue complex

66. Single anterior implant

67. “D” implant in cuspid pillar

68. “D” Posterior bridge abutments