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

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checking it with the curve of the socket, than to work the metal back and forth.

Manual pressure (16) should be adequate to lodge the implant one or two millimeters in the socket to check post alignments with other abutments. With pliers, the neck (17) of each post is bent gradually to the appropriate angle (18) . After all post adjustments have been made, it is time for final seating.

A double-headed seating instrument (19) is appropriate when the posts are either aligned or nearly aligned with the axis of the socket. The head fits over both posts, and aids in delivering simultaneous, equally distributed force to seat the implant. With an assistant's finger supporting the labial crest (20), the implant is tapped until the bottom of its posts sit on the alveolar crest.

If the implant does not seat smoothly, or if one end requires more force to seat or will not seat at all (21), remove the implant and check the socket with the special channel curette (22). Make adjustments if necessary, and re-insert.

If the difficulty results from denser bone in one area, do not widen the socket in the denser area. Simply concentrate more force on the higher post with the single-head seating instrument (23), which may be used to level the implant, or alternate from post to post to completely sink it. If one shoulder still cannot be buried, the implant is removed and the groove in the area is deepened with a 700 XXL bur.

The shoulder set point instrument may be necessary when the implant is acutely angled. With a finger securing one post (24), the

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1 Two cone socket pliers for bending bladevent
2 Double-headed seating instrument
3 Special channel curette



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