surgical ties are used (5) . Continuous suturing is preferred to close tissues after the insertion of a subperiosteal implant (6). Continuous over and under closing sutures are sometimes used for surface to surface contact of tissues (7). Interrupted mattress (Halsted) sutures are most often used for surface to surface contact (8). Purse string sutures are sometimes used around protruding implant abutments (9).

13.  Placing a temporary prefabricated acrylic splint directly over the incised tissues, although often indicated to maintain esthetics and function for the patient can often cause undue problems. The tissue bearing surfaces of the splint should be relieved sufficiently so that it does not compress the sutured tissues. If not enough relief is obtained and if the tissues should become swollen from the operation, then the splint will cause constant pressure to the tissues resulting in severe pain duration which often delays healing.

Leaving the sutured tissues exposed immediately after surgery results in a most rapid and uneventful healing. It is not necessary to immediately splint the blade implants as was often the routine procedures required to stabilize the weaker screws and pin type implants. A properly inserted blade implant can easily support itself without the needed help of a splint. It will not loosen even during the catabolic stages of bone metabolism during the early stages prior to the rebuilding of the bone. If a splint is fabricated it must fit passively and very soft cement with vaseline is used so it can be withdrawn easily without harm to the implants.

14.  Keep the patient on a soft diet for a few days. A diet including all essential vitamins and minerals will encourage uneventful healing. Warm saline mouth washes as well as oxygenated mouth washes are also indicated for quick healing. Ice packs used intermittently for the first few hours after surgery are also often advised on more complicated cases.

15.  Healing of the soft tissues is also enhanced by the use of antibiotics, anti-inflammatory aids and analgesics.

16.  The healed soft tissues must also be carefully handled — especially when taking impressions. As mentioned before, it is imperative not to leave any rubber base material underneath the posts of the blades after the impressions. Since the material contains a lead base it can destroy the underlying hard tissues as well as cause inflammation of the soft tissues.

B. Handling The Hard Tissues

1. Sharp rotary burs with sufficient coolants are imperative for

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