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prosthesis, which is either an all acrylic splint cemented permanently over the implant system with Duralay acrylic (26), or a denture is cemented permanently into position (27). Being that neither prosthesis comes in contact with underlying soft tissues, but instead, remain a considerable distance away, they both act as sanitary bridges. However, often the prosthesis is now designed with various types of passive attachments, to allow extremely excellent retention and yet remain removable (28).

The various sizes, shapes and lengths of the symphyseal blades, anterior and posterior components were brought about from careful measurements of 80 mandibles.

The Sliding Cable-Ramus Implant

Using the basic principles of the five piece system, another system was developed by the author that can solve practically every single problem that exists in the posterior edentulous mandibular body due to insufficient bone. This lack of bone can have been recently created such as by the extraction of teeth, the removal of a failing blade or other type of implant, as well as from the removal of the distal portion of a subperiosteal implant leaving the anterior portion intact. This technique can be accomplished simultaneously on both sides of the arch or unilaterally only de-pending upon the ensuing situation. However, anteriorly there must exist at least one or more well supported teeth or a well functioning anterior subperiosteal implant.

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