This case shows more height anteriorly than is usually needed, fig. 221. The exposure of the bone showed that alveolar bone still existed anteriorly, fig. 222. The implant was fitted directly over the alveolar bone in this situation, figs. 223, 224, with excellent results, so far, for over nine years, figs. 225, 226. X-ray, fig. 227.

Very often, subperiosteal implants have been inserted immediately after or several weeks after teeth have been extracted and the struts were made to pass directly into the sockets, by-pass them or made to fit into predetermined grooves where alveolar bone still existed. This case shows two remaining teeth, fig. 228, that were extracted, fig. 229. Accessory grooves were made between the sockets, fig. 230, and the tissues sutured closed, fig. 231. The implant framework

272