Endosseous blade implants 517

drawback was that if there was not enough dense bone, then there could not be sufficient support for a continuous blade implant. Therefore a support was added across the palate to more closely adapt the implant to its site. The implant is called the palatal bar horseshoe blade.

This patient had had recent extractions (Fig. 11-177). The fibromucosal tissue was incised and separated from the bone. Because of the palatal ex-

tensions needed in this new implant design, most of the hard palate was also exposed, including the posterior nasal spine and greater and lesser palatine foramina. The palatal tissue was then retracted in a posterior direction from the incision. Grooves were planned only for those areas where the alveolar crest was wide. In this particular case they were made in the left posterior alveolar ridge, ending anteriorly just distal to the recent open

Fig. 11-176. A Panorex of the completed maxillary restoration. The mandibular restoration had been successfully functioning for over a year. Since it was one of the earlier cases the prosthesis was prefabricated before the implants were set into the bone. Large holes were made inside the pontics corresponding to the implants and then they were locked to the protruding posts with acrylic resin, which cannot be seen on a radiograph. This method is no longer done since the blades can remain unsupported for many weeks after their initial insertion. (From Linkow, L. I.: Status of oral implants, 1969, Inform. Odontostomat., Vol. 1, 1969.)

Fig. 11-177. The edentulous maxilla with recent extractions. Note the density and irregularity of the fibromucosa.

Fig. 11-178. The knife-edge ridge was only grooved laterally because the anterior portion flared.