508 Theories and techniques of oral implantology

fully heated. The tray was then replaced in the mouth and centric occlusion established.

A palateless denture with deep channels prepared through the tissue-bearing surface corresponding to the alveolar crest was fabricated. Appropriate implants were selected from radiographic studies (Fig. 11-149).

On the following visit the operation was begun by making a single incision from retromolar pad area to retromolar pad area with a sharp scalpel. The incised tissues were reflected with a periosteal elevator to expose the underlying bone. It is much more difficult to reflect maxillary tissue than mandibular tissue. In the mandible the cortical plate of bone is extremely compact, with a smooth surface. an the maxilla, on the other hand, the bone forming the

Fig. 11-148. The edentulous maxilla. Again note that the fibromucosa camouflages the underlying bone.

Fig. 11-150. Implants were tapped into the grooves made in the knife-edge ridge.

Fig. 11-149. A palateless denture was prefabricated with a continuous deep channel to accept the protruding implant posts.

Fig. 11-151. The implants in place. Posteriorly, the double-posted implants were used for added retention of the pros-thesis.