Endosseous blade implants 495

Fig. 11-105. The excess plaster of Paris was removed, while the remaining plaster was allowed to harden.

Fig. 11-106. The tissues were sutured closed.

Fig. 11-107. A temporary acrylic splint was immediately placed over the implant abutments. The right posterior molar also helped support the splint.

radiolucent area at the apex of the lower second right molar, the tooth was temporarily saved because it was firmer than the others.

The extraction sites were so inflamed with gran-
ulation tissue that after all the tissues and denuded
bone had been curetted, each of the sockets blended,
leaving a few tremendously massive craters between
the buccal and lingual plates of bone (Fig. 11-100) .
Three ledges of undisturbed alveolar bone re-
maining between the large sockets—where the pontics
of the original bridge were located—were utilized

as implant sites. Blades were placed in the right molar (Fig. 11-101) and left molar regions (Fig. 11-102), and two vent-plants were inserted into the anterior central incisor region (Fig. 11-103).

Quick-setting plaster of Paris powder, sterilized in dry heat for 30 minutes, was mixed with a sterile saline solution until it was the consistency of sour cream. It was then slowly poured into the large open sockets (Fig. 11-104). While the plaster was still soft (Fig. 11-105), the tissues were tied together with .000 surgical thread (Fig. 11-106). A temporary acrylic splint, cold cured from an original alginate impression of the former bridge, was immediately placed over the abutments (Fig. 11-107) and ground into proper occlusion. It can be noted here that oral antibiotics can be mixed with the plaster of Paris, which can act as a medicinal vehicle. As the plaster of Paris is resorbed, the antibiotic granules are re-leased.

At the next visit the sutures were removed (Fig. 11-108). Gold copings were placed over the anterior vent-plants, and properly fitted aluminum shells were placed over the posterior blade implants (Fig. 11-109). A wax interocclusal record of centric relation, a full lower plaster index, and an upper alginate impression were taken. Duplicate implants were placed inside the plaster index to ensure accurate placement and alignment of the implants in the master stone cast (Fig. 11-110). A one-piece gold superstructure was then cast and fitted in the mouth over the implants and remaining molar tooth (Fig. 11-111). A final wax bite was taken. To get a close adaptation of the tissue-bearing surfaces of the forth-coming porcelain prosthesis, the gold superstructure