Mandibular Implants (published 1977)   Dr. Leonard I. Linkow

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be delayed 3 to 4 weeks until new bone fills the sockets". I feel that if we flatten the ridges in order to relieve the undercuts, then the occlusal table of the ridge usually becomes wider.

When an open socket remains between two teeth and only a single tooth blade can be inserted wait three months for the socket to fill in with bone before inserting the blade. In an open socket where neighboring teeth have been missing for some time a blade can be inserted through the socket and extended mesially and distally to it into good bone. If the buccal or lingual plates on one of them were destroyed insert the socket blade making sure, however, to bury the recessed shoulder to its proper depth beneath the most resorbed cortical plate. A curved groove around the socket could be made to place a blade into the bone providing the bucco-lingual thickness of the bone, labial or lingual to the socket was thick enough to avoid the socket.

In situations when an open socket exists and an implant is not used and a bridge is fabricated before the socket fills in with new bone, it is necessary to make sure that the pontic be made deeper and partially into the socket so that it will help compensate for shrinkage that will take place. When a number of sockets re-main and the bridge is completed lengthen all of these pontics gingivally but wherever possible use soft cement only to hold the bridge and wait about six weeks before sending the bridge to the laboratory for reprocessing.

Overerupted teeth can be treated in the same manner as the upper molar. Retaining these teeth would become more necessary in those cases where poor ridges exist mesial and distal to it possibly preventing the insertion of blades. If excellent bone flanks the overerupted teeth and blades can be inserted it might be wiser to remove the teeth.

Only when an extremely excessive amount of labial bone exists is it necessary to reduce the thickness. Dean's method for implants would be the best since we are interested only in reducing the labial aspect and not the palatal. In those cases where anterior teeth exist with such extreme oblique axial inclinations than they might be extracted; a good part of the labial bone would "fall inward" and three months later the blades could be inserted with far less of an axial inclination than the original teeth had.

When the maxilla resorbs it resorbs in a bucco-palatal and labio palatal direction medially making the overall size of the maxilla narrower than that of the mandible (it also resorbs obliquely to a horizontal plane) . A routine alveolectomy in order to

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