It is imperative that no bending takes place while the ramus miplant is in the mouth.

The coping is then carefully tapped off of the bladevent post, thereby, once again tipping the ramus horizontal extension arm upward away from the occlusal plane (20). This is done so the extension arm can disengage from the anterior component, so they can be cemented firmly into position. The extension arm and anterior component as well as the bladevent post are thoroughly dried, and with a special plastic tuberculin syringe, a loose mix of Duralay acrylic cement is expressed into both ends of the anterior component blade post and extension arm, tube and coping (21) . The anterior component slides over the ramus extension arm and the entire mechanism is guided downward until once again the anterior coping fits snugly over the rounded post of the symphyseal bladevent (22). Two holes at the surface of the tube allows for excess amount to "ooze" out, thus preventing air pockets within the cement itself (23).

The same procedure is carried out on the opposite side of the arch. The tissues are sutured closed, although often I now do not suture the tissues in the ramus area, thus allowing them to fall properly into place, and a temporary fixed splint (24), created from an Omnivac machine is fabricated, or the patient's original denture is severely hollowed out and relined with a hard or soft acrylic, making sure it does not lock beneath the horizontal bar (25). A week later the sutures are removed, and when the tissues are sufficiently healed, an alginate impression is taken to include the entire implant, and an interocclusal record of centric relationship is taken, and an opposing jaw alginate impression to complete the

116