566 Theories and techniques of oral implantology

pins, the bone was traversed palatolabially, high in the area of the canine eminence (Fig. 12-87). The bur should go completely through the bone in a slightly upward and distal direction. A second twist drill of the same diameter was then drilled through the bone in the area of the canine eminence, but mesial to the first bur and in a mesial direction. Both transfixation pins were then inserted completely through the two holes made in the bone (Fig. 12-88). Both were then

backed out so that their palatal ends were flush with the palatal bone.

An impression of the exposed bone was taken with a specially prepared partial tray   fabricated by removing its labial flange and with one of the elastic impression materials. At least one tooth on each side was also included. With the impression material still in the mouth, the pins were immediately pushed palatally before the material set.

A

C

E

B

D

F

Fig. 12-98. A, Another case showing two transfixation pins of a much larger diameter than those of the previous case. B, The horizontal transfixation pins were placed back into the elastic impression. C, The subperiosteal implant was closely fitted to the bone. Note the circular hole at the superior peripheral border of the implant. D, The transfixation pin was placed through the hole on the labial border and traversed the bone horizontally to end through the other side of the hole on the palatal aspect. E, The tissues were sutured so that they closely adapted to close the incision. F, The completed case—an all-acrylic full arch splint processed over gold copings.