Subperiosteal Dental Implants: A viable alternative?
Subperiosteal dental implants are for patients with insufficient bone volume to receive traditional endosteal implants. These implants are custom-fit frameworks that the dentist places beneath the periosteum (the membrane covering the bone) but above the jawbone. This technique bypasses the need for extensive and risky bone grafting, making it a viable option for certain complex cases.
Indications and Procedure
Subperiosteal implants are for patients with severe bone resorption that lack the bone volume for traditional implants. The procedure typically involves two stages. First, the dentist creates an impression of the jawbone, using a CT scan. In the second stage, a custom-fabricated framework is surgically positioned on the bone. Surgical screws hold the prosthesis in place. The design will have abutments for teeth and those abutments will stick up through the gingiva.
Advantages and Challenges of the Subperiosteal Dental Implant
One of the main benefits of subperiosteal implants is their adaptability for patients with significant bone loss, eliminating the need for invasive bone augmentation procedures. However, the technique has some challenges, including a higher risk of infection and long-term complications compared to endosteal implants. Success rates are also highly dependent on the precision of the surgical procedure and post-operative care. In other words, there are not many surgeons with the skill and experience to do these well.
Advances and Outlook
Recent advancements in imaging and manufacturing technologies, including 3D printing and CAD/CAM systems, significantly improve the customization and success of subperiosteal dental implants. Companies like Panthera have very nice looking products for mandibular cases. The innovations enhance the fit and reduce the likelihood of complications but also are pushing the category into new uncharted water. For instance, El-Sawy JPD 2024 shows a maxillary case utilizing PEEK material.
Currently options like all on 4 and zygomatic implants seem to be better accepted and are certainly far more common as options for patients.
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