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

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Caution: After any form of alveoplasty, the implant site must be re-evaluated to ensure that a previously selected implant design is still appropriate.

Before final seating, the implant is tried in its socket and the alignment of its post checked with that of the neighboring teeth (27). Often the neck (28) must be twisted so that the post will follow the arch line. This is particularly important in anterior sites for the construction of a natural-looking, non-bulky restoration.

A single-headed inserting instrument is used with a finger sup-porting the labial plate. A few taps should sink the implant to its proper depth, with the bottom of its post touching the top of the ridge.

The single-tooth bladevent is the only bladevent design that must be immediately stabilized after insertion. The method of stabilization will depend upon its location, the condition of the neighboring teeth, and the type of final restoration.

The single-tooth implant can serve an important function when a mandibular cuspid is missing by insuring osteogenic stimulation within the canine pillar. This column of bone allows the lip to re-main symmetrical to its other side.

As the underlying bone shrinks in the canine pillar region, the lip drops in the area—a tendency noteworthy for its cosmetic implications. Thus an implant can provide more benefit than a conventional restoration whose prime functions are space maintenance and providing a chewing surface.

Anterior Tooth Replacements

The decision to use an implant in a one or two-tooth anterior span depends primarily upon the condition of the remaining teeth and their supporting tissues. Neighboring teeth with good bone support (1) are usually adequate anchors for a prosthesis without the use of an implant. An implant might be considered to promote osteogenesis, but in such a short span the neighboring teeth usually provide adequate stimulation.

Frequently the cause of tooth loss affects neighboring teeth as well, and they are either unstable or in a precarious situation (2). In such cases an implant can provide additional support for a prosthesis. It may relieve the teeth of otherwise unbalanced occlusal forces and prevent the further deterioration of their situation. Bone

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1 Twisting the neck of  dental implant according to arch line
2 Well bone supported teeth are good anchors for dental prosthesis
3



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