Tissue considerations for mandibular subperiosteal implants.
The criteria for the preoperative evaluation of the residual alveolar tissue for a potential implant patient have been discussed. To ensure a firm epithelial attachment around the implant post, the residual tissue at the point of oral penetration should be: (1) sufficient in amount or thickness and attached to the periosteum, (2) fibrous, not loose, areolar mucosa, and (3) positioned midway over the stress-bearing area for the implant and overlying prosthesis. If the existing tissue does not meet the above criteria, a free palatal graft can be placed over the point of oral penetration to improve the potential for tissue adaptation around the post.