Background: Bone regeneration is a reliable technique when the bone volume is insufficient to provide a functional and aesthetic outcome in surgery and implantoprosthesis procedures. When bone blocks are used but do not match the shape of the defect, the block must be adapted. The aim of our research was to evaluate, by Scanning Electron Microscopy (SEM) morphological observation, how different cutting devices modify the bone surface. Method: Four equine bone blocks were divided into 15 cubic shape samples with ultrasonic and sonic tips, as well as diamond, tungsten carbide, and Lindemann burs. The uncut surface of the obtained bone block was used as a control. Two observers independently analyzed the SEM observation recording, including cut precision, depth of incision, thermal damages, and presence of bone debris. For each group, sharpness, depth, carbonization, and bone debris were expressed as mean values. Results: The osteotomy performed with an ultrasonic tip shows the best results, preserving the bone morphology in both quantitative and qualitative analyses. The bone surface appeared sufficiently clean from debris and showed a reduced presence of carbonization. Conclusion: The shaping of the bone block as in vivo osteotomy respects the bone morphology and allows it to achieve the relevant biological and clinical outcome.