Considerations for three dimensional implants.
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Biomedical subjects
Publications and source records attributed to M S Mahler.
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In trying to trace the emergence of the sense of self during the first fifteen months of life--in particular the formation of the bodily self--we used, on the one hand, severe dissociations of the integral parts of the body self such as occurs in psychosis, in the Gilles de la Tourette syndrome, and in phantom-limb disturbances and, on the other hand, data from our normative study of the separation-individuation process as inferred from mother-infant interaction in general and the infant's behavior in front of the mirror in particular. The infant's behavior in front of the mirror strongly suggests that feelings about himself only gradually become integrated with perceptual and cognitive awareness of himself. All the data, furthermore, indicate that it is not possible to study the development of the self separate from the development of the object. All inferences contained in our paper about the emergence of the sense of self were made from the point of view of the central organizing, integrating, and synthesizing institution of the mind, that is, the ego. We agree with other authors that the developing self has both experiential and structural aspects. We titled our paper "Thoughts on the Emergence of the Sense of Self" to indicate that this paper is meant to be an initial and quite tentative communication about the vast and elusive area of personality development concerning the emergence of our bodily self, and thus of the core of our personal identity.
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For those individuals whose oral anatomy contraindicates the use of endosteal implants, there still remains a viable alternative to conventional removable dentures. Both maxillary and mandibular implant dentures of a subperiosteal design will provide a stable implant and a retentive restorative prosthesis. The patient is free from the oral gymnastics required to manipulate such appliances and in the maxilla the dentist is able to eliminate all palatal coverage without compromising the retention of the bridge. The lower subperiosteal implant and the pterygoid extension implant discussed both obtain their stability from accurate fit of the implant substructure to the bone. The implant first becomes more retentive when the periosteum tenaciously reattaches itself to the bone and in turn secures the implant in position (Fig. 13). The restorative procedures follow sound prosthetic prinicples with particular attention on avoiding any impingement of the underlying tissue areas. Implant dentures have truly provided patients a means of exploring alternative treatment modalities other than conventional removable dentures. Literally thousands of patients today are living testimony to the accomplishments of oral implantology when pursued as an exacting science prescribed by colleagues experienced in this revolutionary dental discipline.
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