In these totally edentulous cases, fig. 77, great care must be taken to cleanly expose the bone and making sure not to stretch or cut the neurovascular bundles, fig. 78. This impression was done with heavy and light Imput material without a tray, fig. 79. The top of the heavy bodied material is then notched with bur marks to allow more of the same material to adapt to it while taking the bite relationships, fig. 80. The impression must include a good peripheral roll of the external oblique ridges, the symphysis, the mylohyoid ridges, the genial tubercles and the bundle of nerves and vessels exiting the mental foramina, fig. 81.

The tissues are sutured together, fig. 82. At the next visit, preferably three weeks later after the tissues have healed from the first surgical visit, the implant is inserted, figs. 83, 84, 85, and the tissues are sutured closed, fig. 86. The patient leaves the office with the temporary acrylic denture, fig. 87. Healing can take anywhere from three to six weeks, fig. 88. The completed case, fig. 89, and x-ray, fig. 90.

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