334 Theories and techniques of oral implantology

Fig. 8-84. A, An immediate postoperative radiograph of the pins inserted into the open socket and fastened together inside the crown with acrylic. B, A 14-month postoperative radiograph shows the fill-in of bone.

Any post type implant is usually far too narrow in diameter to fit the empty socket. No matter how well it is secured to abutment teeth, it will move in the socket. Soft tissue will invaginate and the implant will always be loose.

Rarely is there enough bone left between the socket and an anatomic landmark so that the implant may be driven beyond the socket. Attempting to insert triplant pins usually results in perforating the cortical plates of bone, an obvious error.

Some specially designed implants have been suggested, such as Linkow's twisted pins, shown in Fig.

8-83. These are bent during the intervention to fit the socket and their ends driven into holes and crevices specially drilled for them. Although they may work (Fig. 8-84), the unstandardized, off-the-cuff insertion procedures invite mistakes.

To date, the most promising implant for open socket use is the blade-vent. Extremely wide in a mesiodistal direction, it can span the socket and be secured in relatively solid bone. Results so far have been good, but it is still too early for long-term conclusions.