Q. Explain about Mandible?

In the mandible, attached keratinized tissue normally atrophies with the underlying bone. As a result there is generally a relatively narrow band of attached tissue available. Typically, in the mandible a crestal incisions is made which bisects the attached tissue, thus positioning the keratinized tissue on the lingual and labial aspects of the implant.

There is no attached tissue available for manipulation on the lingual aspect of the mandibular ridge. On occasion, however, when minimal ridge resorption has taken place there may be thick band of keratinized tissue on the crest and the labial aspect of the ridge. It is therefore sometimes possible to use this tissue for papillary reconstruction, if required. Mandibular tissue is easily mobilized and therefore readily adapted around the implant.

The full thickness incision is indicated for:

• Exposure of multiple implants adjacent to each other.
• Implants where the position cannot be accurately identified
• Single or multiple implants requiring papillary reconstruction
• Repositioning of keratinized tissue.

A full - thickness incision is made on palatal aspect of implant. The flap is reflected to expose the implant, thus mobilizing the attached tissue towards the labial aspect of the implant. With the abutment inserted into the implant this would result in a deficiency of tissue on the mesial and distal aspects of the implant. The closure of this deficiency will depend on the need to create a papilla.