Maxillary Implants (published 1977)   Dr. Leonard I. Linkow

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Caution: To bend the neck of the post, grasp the body of the bladevent perpendicular to its length where the neck meets the shoulder (25). Do not grasp the entire length of a curved blade (26) with the pliers. Such a grip would flatten the carefully created, accurate curvature.

Caution: The bladevent's neck should not be bent in the mouth with the bony walls of the socket used as a vise. This would crush living bone cells and possibly fracture the walls.

When all abutments are satisfactorily angled, the individual bladevents are ready for final seating.

The socket is cleaned of debris with water and a special channel curette (27). This instrument is designed to help detect unevenly deep, improperly prepared sockets. If the tool pops up while passing it along the base of the socket, an obstruction (28) is indicated. This must be removed with the 700 XL bur to seat the blade evenly.

The sterilized implant is replaced. It must now be seated to its proper depth with some type of inserting instrument and a mallet. Because force should be directed along the axis of the socket, the final seating method must be carefully executed.

A single-headed seating instrument (29) works very well in-deed if the neck of the post is only slightly bent and the implant is correctly engaged in good bone. Even so, a finger is needed to brace the labial plate (30) .

Caution: If the post has been bent acutely away from the axis of the socket, the seating instrument cannot be used on the post. The force against labial bone (31) might fracture it. In such a case, the implant's shoulders must receive the force. Most bladevent de-signs have a small pit in each shoulder to secure a pointed seating instrument (a shoulder set point) (32). This is inserted in one shoulder and aligned with the axis of the socket (33).

An assistant's finger holds the unengaged shoulder to prevent its popping up. A sharp tap should sink the implant a short distance and then the instrument is alternated to the other shoulder.

Caution: Do not pound down one shoulder, then the other, or allow an unsupported implant to be rocked mesio-distally (34). Uneven, forceful seating injures the mesio-distal borders of the socket, and working the implant up and down widens the socket.

The sharp-pointed inserting instrument fits easily between the walls of the socket, making it possible to sink the implant to its proper depth without traumatizing bone at the crest.

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1 Implant socket is cleaned of debris with water and channel curette
2 A single headed seating instrument for maxillary implantation
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