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

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Caution: Work cautiously with the pliers near the crest. A slip or pinch of the pliers can easily bruise or fracture bone.

Any lack of parallelism of the posts after the implants are fully seated can be adjusted with the 700 XL bur without dislodging the implant. The post height can be shortened with the 700 XL bur or a heatless wheel—always with water. This type of paralleling should always be done immediately after the implant is inserted so as to allow for easy insertion and removal of a temporary splint, also to avoid having to do this procedure at a later time when the bone is undergoing catabolic changes which could cause dislodgement of the implant.

 

 

Problem Ridge: Limited Space

Space in which to work may be limited for two entirely different reasons. The presence of natural teeth may make it difficult to maneuver an implant into bone between the teeth and avoid the roots. In such a situation, the implantologist is usually working under relatively favorable conditions, i.e. in fair to good bone sites. The other reason is bad news: extensive resorption has left almost no ridge and nondental anatomic features may be threatened by implant procedures. Either situation—good or bad—requires versatility and ingenuity on the part of the operator.

Single-Tooth Bladevents. The single-tooth bladevent differs in de-sign and, in many ways, use from all other bladevents. It was designed to fit into a one-tooth edentulous span. Because the proximity of neighboring teeth limits its horizontal dimension, the implant must gain its mechanical advantage by vertical extension in bone. In this way the single-tooth implant is more like a natural anterior tooth than it is any other type of bladevent design. Its unusual height—slightly longer than a central incisor—limits its use in the mandible to areas in front of the mental foramen. Only here is the bone potentially deep enough to accept this tall design.

The single-tooth implant can be used when only one tooth in the entire arch is missing (1) or in a one-tooth span. Or in an arch with several other missing teeth (2). The condition of the remaining teeth and of the bone, as well as the location of the tooth loss, determine how the implant will be used.

There are two basic, single-tooth implant situations. The first is to provide a base for a single-unit, fixed restoration that does

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1 Use of single tooth implant in arch with one or several teeth missing



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