It is my opinion that the bone can be stimulated in another manner. The wedge shape of the blade with the encapsulating fibrous tissue membrane can, through the intermittent pressure to the bone, cause a stimulating effect. Because the bone has a visco-elastic characteristic, the wedge can act as a minute hydraulic system, provided that a deep enough groove was made so that the blade could easily and gently be tapped into position without spreading the bone beyond its physiologic limits.

In 1971 I developed still another dimension in implantology which could very well have a great impact on dentistry. It replaces the maxillary subperiosteal implant designs for the totally and partially edentulous maxillae, which failed, because of their designs and eliminates these problems very efficiently. I call it the pterygoid extension implant, which was described in great detail in Volume I.

My latest five piece symphyseal-rami implant system replaces the mandibular subperiosteal implant in those situations where the mandibular canals and foramina are exposed. They will be thoroughly illustrated and described in this volume.

Implantology is a science but even more so, it is an art. When techniques and procedures are abused, failure can result. When executed by skilled, educated dentists with a thorough knowledge of the multi-discipline it must be considered the greatest advance in modern day dentistry.

An implantologist's attitudes toward morphology and prosthesis design differ from those of the dentist planning a conventional restoration. It is not a question of who is right or wrong, but of which method is used to compliment their techniques.

The totally or partially edentulous patient presents his case. The conventional prosthodontist selects a set of characteristic surface features, and designs his restoration to them. However, eliminating the alternatives does not produce The Only Solution; it is merely a convenient approach, based on frequently neglected observations in our field substantiated by clinical success and histological evidence.

Although the techniques demonstrated may seem difficult and radical, any skilled practitioner, given adequate guidance can learn to use implants to expand his therapeutic alternatives.

The following pages, which summarize some of the considerations involved in an implant procedure, are intended to stimulate the reader prior to reading the text. I look forward to sharing my enthusiasm with you.

Leonard I. Linkow

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