52 Theories and techniques of oral implantology

area of the inaudible where the body meets with the ramus; it is constantly involved during opening and closing of the jaw. For this reason, it should be avoided whenever possible.

The most detrimental effects on healing can result from poor surgical techniques. For example. when incising extremely thin tissue, it is imperative to incise it exactly iii the area desired, since thin tissue has a tendency to pull away or tear with just it little help from the scalpel. Therefore an incision intended for the crest of the ridge might very well be too far labial1v or lingually. This could be tremendously detrimental to the fate of the implant. Suturing an incision stretched in too many undesired directions will prevent complete initial healing over the implant base. The incision should lie directly over the crest of the alveolar ridge.

Violent reactions, including inflammation, swell

ing, and rapid and resorptive necrosis of both the hone and soft tissues can occur by simply leaving small pieces of rubber base impression material, plaster, wax, or acrylic in the implant site. This is unfortunately easy to do, since small bits of these materials can be easily overlooked in the deeper portions of the bone, such as below the undercut area of the mylohyoid ridge or external oblique ridge. It is imperative that the operator make doubly sure that none of these materials remain before suturing.

Understanding of the tissues involved is vital to an operator contemplating an implant intervention. By recognizing the normal structure and activities of a tissue, he can better plan his choice of approach, anticipate possible operator} problems, and knowledgeably follow up his patient's progress.