Ramus Frame Implant Revisited

Figure 1. The atrophic mandible may not adequately support or retain a mandibular complete denture, so retention and support can be provided by a ramus frame implant. Figure 2. Panoramic radiograph of the atrophic mandible demonstrates inadequate bone for screw-type dental implants but adequate bone at the symphysis and the ramus for placement of a ramus frame implant. Figure 3. Initial incision bisecting attached gingiva with releasing incisions. Figure 4. Anterior osteotomy prepared with highspeed surgical drill. Figure 5. The anterior osteotomy is completed. Figure 6. Anterior foot analog is tried-in and the osteotomy is adjusted to accept the analog.

Figure 7. The ramus osteotomy is performed. Figure 8. Posterior osteotomy is completed to accept the posterior foot. Figure 9. Try-in of the posterior foot analog. Figure 10. Insertion of the ramus frame implant with posterior feet inserted first. Figure 11. The ramus frame is inserted in the mandible and voids are filled with particulate osseous graft material. The site closed with nonresorbable suture.

Figure 12. The panoramic radiograph of installed ramus frame implant. Figure 13. Stock transitional denture try-in. Figure 14. The intaglio of the removable complete denture after reline features a slot that engages the ramus frame superstructure for support and retention. Figure 15. Transitional denture after occlusion adjusted. Figure 16. Ramus frame implant after uneventful healing.