Transosteal implants are very seldom used and only a small number of dentists use this technique. The Transosteal implant approach involves drilling all the way through the lower jaw, bolting a plate onto the the bottom of the jaw with nuts on top, where a denture is then mounted on the screws which protrude through the gums. The system requires opening the skin below the patient's chin with the possibility of unsightly scarring. It is Dr. Martin's opinion that this system is unnecessarily invasive and has a high failure rate.