Comparative Evaluation of Chisel - Mallet, Rotary Bur, and Bone File Techniques in Surgical Alveoloplasty (1951–2025): A Biological and Clinical Outcome Synthesis

Abstract

AbstractBackground: Alveoloplasty is a fundamental preprosthetic surgical procedure designed to eliminate sharp alveolar bone irregularities and optimize ridge morphology for prosthetic rehabilitation. Over time, the procedure has evolved from mechanically aggressive techniques such as chisel mallet osteoplasty to more controlled rotary bur based contouring with bone file finishing.Objective: This systematic review evaluates and compares three major instrumentation approaches chisel mallet, rotary bur, and bone file techniques in alveoloplasty, focusing on postoperative pain, swelling, infection, flap necrosis, suture stability, and overall healing behavior.Methods: A structured narrative systematic review of literature from 1951-2025 was conducted. Evidence was extracted from experimental studies (Horton et al., 1975), clinical comparative trials (Gangwani et al., 2018; Pandey et al., 2022), biomechanical bone studies (Otake et al., 2018), and surgical technique literature (Osborn, 1985; Eliasson, 1996; Hupp et al., 2004).Results: Rotary bur based alveoloplasty consistently demonstrated superior outcomes in reducing postoperative morbidity and improving precision. Bone files played a critical adjunct role in final ridge smoothing. Chisel mallet techniques showed higher biological trauma and less predictable healing patterns.Conclusion: A hybrid technique combining rotary bur contouring with bone file finishing provides the most favorable clinical outcomes. Chisel mallet techniques should be reserved for selective cases requiring gross ridge modification.