254 Theories and techniques of oral implantology

It should be done against a full upper denture. Linkow has developed a technique whereby the entire floor of the mandibular canal is lowered while the nerve bundle is carefully lifted out of the canal. In the same manner, a new mental foramen is established by careful surgical technique. The nerve is lowered into the newly formed canal, thereby being protected from the overlying prosthesis.

Often a great deal of alveolar bone exists in the mandible above the canals and mental foramina (Fig. 6-62). This is an ideal situation for endosseous

implants, and several approaches may be taken. A full arch fixed denture can be fabricated utilizing four blade implants. Blades with a single abutment post can be placed in the area of each cuspid and, posteriorly, on each side a double-posted blade may be used. In this manner, although only four blades are to be inserted, six protruding posts will provide a great deal of retention for the fixed superstructure.

Screw type implants can also be used, placing from six to eight into the bone. These may support

Fig. 6-66. The maxillary tuberosity areas may be used as sites for blade implants only.

Fig. 6-67. Blade or pin implants may be placed anteriorly or posteriorly to the maxillary sinus in this case.