Subperiosteal personalised implants for the rehabilitation of the severely deficient edentulous maxilla. Revision of a clinical series of 8 cases

Abstract

Introduction: Customized subperiosteal implants are presented as an alternative in the implant-supported rehabilitation of patients with severe bone atrophy. This article describes our experience in their use for complete maxillary rehabilitation. Patients and methods: A retrospective study of 8 edentulous patients with severe maxillary bone atrophy treated with customized titanium frameworks designed and manufactured in conjunction with Avinent Digital Health (Barcelona, Spain) is presented. The frameworks are designed based on a thin-slice maxillomandibular CT scan. A full acrylic prosthesis with radio-opaque markings is used as a reference guide. The structures are designed in two or three pieces to favor their insertion and adaptation to the bone contours. The surgery is performed under general anesthesia, and includes bilateral buccal fat pad flap prior to mucosal closure. Immediately after surgery an implant-supported temporary fixed prosthesis is placed, which is replaced by a fixed ceramic or hybrid prosthesis after 8-12 weeks. Results: All patients are currently wearing the final fixed prosthesis, with a follow-up time of 4 to 36 months. In no case has it been necessary to remove or trim the implant. All patients are asymptomatic. Conclusion: Although this is a preliminary study, the results indicate that this technique should be considered as a treatment alternative in severe maxillary atrophy.