Linkow 5 piece ramus system with anterior subperiosteal

When not enough bone exists in the symphyseal area, (Fig. 1) prohibiting an anterior blade to be inserted there, for fear of perforating the inferior border of the mandible or fracturing the bone itself, an incision and impression for an anterior partial subperiosteal implant is done (Fig. 2). The posts, however, of the subperiosteal casting are fabricated to fit the prefabricated hollowed out anterior connecting tube copings. The cast subperiosteal implant is then fitted over the exposed bone and with two small Vitallium screws, it is screwed into place, (Fig. 3) and sutured (Fig. 4). The posts are shortened if necessary.

The anterior components are once again tried over the shortened posts and are adjusted, so that they fit to the gingiva and swing buccally and lingually with no resistance from the underlying posts. The right ramus groove is then made, (Fig. 5). The various sized ramus components are fitted into the groove, until the proper size coordinates most closely with the anterior symphyseal blade post of its corresponding size, (Figs. 6, 7, & 8) . The procedure is repeated on the left side, (Fig. 9).

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