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

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might benefit, around the teeth being saved from further trauma

and around the implant receiving osteogenic stimulation.   

The narrow, single-tooth bladevent (3) is usually the most appropriate design for an anterior two-tooth span. Whereas another narrow design (4) might fit into the span, its post would protrude interproximally (5), requiring the addition of unesthetic, unnatural bulk in the restoration. (Note: "Single-tooth" bladevent refers to a specific, atypical bladevent design so narrow that it can fit into a single-tooth anterior span. The term does not refer to the number of teeth to be replaced.)

Some individuals have very little bone (6) between the apex of the tooth and the inferior floor of the mandible. Thus when the tooth is lost, usually as a result of bone loss, there may be insufficient height to accept a standard single-tooth bladevent. Others may have lost an unusual amount of height (7) due to a traumatic extraction or some other factor. In such cases the implant's legs can be cut down to reduce the implant's height. Or, a shorter design can be angled (8) into the ridge and its neck bent to center (9) the post under the proposed restoration.

An implant socket between teeth is made according to the same surgical dictates as in a totally edentulous ridge. The socket is initiated slightly lingual to the center of the crest and inclined to leave more bulk on the labial side of the ridge.

Bone density will determine how deep the socket should be made. The socket should be drilled to its fullest depth (10) with a 700 XXL bur if the bone is dense. In a more porous ridge, 2-3 millimeters of bone may be left (11) to be interrupted by the legs of the implant. However, in the anterior mandibular arch the bone may progress from porous at the crest to very dense as the bur travels more inferiorly. Increasing resistance to the bur in deeper bone indicates this, and may necessitate using a fresh bur to avoid excessive friction. When the socket is acutely angled it is drilled to

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1 Single tooth bladevent
2 Unusual amount of bone loss in mandibular arch
3 Implant socket depth based on mandibular bone porosity



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