Atypical implant situations 663

Fig. 15-110. Fixed bridge stabilization procedure when a terminal abutment tooth has loosened. A, The groove has been prepared for the implant. It was necessary to remove the buccogingival third of the pontic to approach the bone properly. The pontic was also hollowed out at the same time. B, The special blade is set into the prepared groove. C, After the blade has been tapped into the bone, its abutment post (in this case, a screw) is inserted. D, Cold cure acrylic resin is brushed on to secure the post and to rebuild the pontic. Lateral view shows a double-posted implant used as a fixed bridge stabilizer.

face of the pontic, if removed, is also restored. When the acrylic hardens, it is carefully trimmed and polished. Finally, the incised tissues are cleansed and rejoined with sutures, which are removed in about 1 week. The loose terminal abutment teeth—as well as the bridge   are now stabilized.

FUTURE APPLICATIONS FOR ENDOSSEOUS IMPLANTS

Because endosseous implant techniques have been so successful in fixed denture situations and in providing the only solution in some atypical cases,

Fig. 15-111. Diagram of a proposed method of stabilizing a fracture in an edentulous mandible. After blades are placed on both sides of the fracture, it is reduced. An elastic impression of the implant posts is taken while the fractured elements are held firmly in their proper relationship. From the impression a fixed superstructure is fabricated and cemented with hard cement over the posts. The super-structure splint holds the joined ends of the fracture and immobilizes them until healing takes place, 6 to 8 weeks later.

Fracture