Besides clinical observation, fig. 109, the pre-operative x-ray is the determining factor as to whether or not the patient is a subperiosteal implant candidate, fig. 110. From accurate impressions the subperiosteal implant is fabricated, fig. 111, and fitted and sometimes screwed to the bone, figs. 112A, 112B. Sutures are applied using circumferential mattress and simple surgical interrupted sutures, where necessary, fig. 113. Often, at the same visit the superstructure is fitted and picked up with an elastic impression to save the patient a week's waiting for the completed implant denture, fig. 114. Notice the longer posts that are so much needed in this extremely resorbed mandible, fig. 115. The finished case, fig. 116, and 7 year post-operative x-ray, fig. 117.

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