Subperiosteal Implants

Subperiosteal implants are a specialized type of dental implant used primarily for patients who have insufficient jawbone to support traditional endosteal implants. These implants are placed beneath the periosteum, which is the tissue that covers the jawbone, making them an alternative for individuals who may not be candidates for standard implants due to severe bone loss. Subperiosteal implants offer a solution for people with limited bone volume in the upper or lower jaw where bone grafting may not be an option. This type of implant system involves a surgical approach that requires careful planning and precise placement to ensure success.

What Are Subperiosteal Implants?

Subperiosteal implants are dental implants placed under the periosteum but above the bone. The periosteum is the membrane that covers the surface of the bones. Unlike endosteal implants, which are inserted directly into the jawbone, subperiosteal implants rest on top of the bone but are still beneath the soft tissue, making them ideal for patients with insufficient bone volume in their jaws.

The structure of subperiosteal implants consists of a metal frame that is custom-made to fit the contour of the patient’s jawbone. This frame has posts attached to it, which protrude through the gum tissue to hold the dental restoration, such as a crown, bridge, or denture. These implants are typically used when there is not enough bone mass to secure traditional implants or when other surgical procedures like bone grafting are not suitable.

When Are Subperiosteal Implants Used?

Subperiosteal implants are used in specific cases where other dental implant options may not be possible. They are typically recommended for patients who have experienced significant bone loss in the jaw, particularly those who are not candidates for bone grafting. In some instances, subperiosteal implants may be an option for patients with medical conditions that prevent the use of standard implants or those who are unable to undergo lengthy or invasive procedures like bone grafting.

Patients with severe bone atrophy, especially in the upper jaw, may benefit from subperiosteal implants as they can be customized to fit the available bone structure. This type of implant provides a solution for individuals who have worn dentures for many years, leading to bone resorption that makes traditional implant placement unfeasible.

The Procedure for Subperiosteal Implants

The procedure for placing subperiosteal implants is more complex than traditional dental implant procedures due to the nature of the implant’s placement beneath the periosteum. Here’s a general overview of how the process unfolds:

Consultation and Evaluation

The first step in receiving subperiosteal implants is a comprehensive consultation with a dental professional or oral surgeon. During this visit, the dentist will examine the patient’s mouth, review their medical history, and assess the condition of the jawbone. Advanced imaging techniques like CT scans and 3D imaging are often used to gather detailed information about the jaw’s bone structure and the condition of the surrounding tissues.

The dentist will also take into account the patient’s overall health and any medical conditions that may affect the procedure. After a thorough evaluation, the dentist will determine if subperiosteal implants are a suitable option.

Customized Implant Fabrication

Once the dentist decides that subperiosteal implants are appropriate, an impression or scan of the patient’s jaw is taken. This is done to create a custom-made metal frame that fits the contour of the jawbone. The frame is designed to rest just under the periosteum and to ensure proper stability and alignment. The posts are also designed to protrude through the gum tissue, where the dental restoration will be placed.

The creation of the custom frame may take several weeks, as it needs to be precisely manufactured to ensure a perfect fit. The patient may be required to wear a temporary prosthetic during this waiting period.

Surgical Placement

Once the custom implant frame is ready, the next step is the surgical placement. This procedure is typically done under local anesthesia, although sedation may be used depending on the patient’s preference. The oral surgeon makes an incision in the gum tissue to expose the jawbone and place the subperiosteal frame.

The frame is carefully positioned beneath the periosteum and placed securely on top of the jawbone. The posts protrude through the gum tissue to provide a secure foundation for the dental restoration. Once the frame is in place, the incision is closed, and the patient begins the healing process.

Healing and Integration

The healing process for subperiosteal implants is crucial to the success of the procedure. Since the frame is placed beneath the periosteum and above the bone, the healing time can be longer than with traditional implants. The posts need time to fuse with the surrounding tissue to ensure stability.

The healing period typically lasts several months, during which the patient will be monitored regularly by the dentist. The dentist will check the progress of the healing process and make sure the frame is securely integrated into the tissue.

Placement of the Restoration

Once the healing period is complete, the final step is to attach the dental restoration, such as a crown, bridge, or denture, to the posts that protrude through the gums. This part of the procedure is typically completed in a single visit and involves the dentist securing the restoration to the posts, ensuring that the patient’s bite and alignment are correct.

After the restoration is placed, the patient can resume normal activities with a fully restored smile. Subperiosteal implants provide both functional and aesthetic benefits, allowing individuals to eat, speak, and smile confidently once again.

Advantages of Subperiosteal Implants

There are several advantages to using subperiosteal implants for dental restoration, particularly for patients who have insufficient jawbone:

• Suitable for Patients with Insufficient Bone: The main advantage of subperiosteal implants is that they can be used in patients who do not have enough bone to support traditional implants. This provides an alternative for individuals who cannot undergo bone grafting or other procedures to increase bone volume.

• Reduced Need for Bone Grafting: Subperiosteal implants do not require bone grafting, which is often necessary for traditional implants. This can save time, reduce the overall cost, and make the procedure less invasive.

• Improved Functionality: Subperiosteal implants offer the same functionality as traditional implants, allowing patients to chew, speak, and smile confidently. They provide a more stable and comfortable solution than removable dentures, which can slip and cause discomfort.

• Customizable Design: Since subperiosteal implants are custom-made, they can be designed to fit the patient’s jaw precisely. This ensures a better fit, greater comfort, and improved aesthetic results.

Challenges and Considerations

While subperiosteal implants offer a solution for patients with insufficient bone, there are some challenges and considerations to keep in mind:

• Complexity of the Procedure: The surgical placement of subperiosteal implants is more complex than traditional implant placement. It requires a higher level of skill and experience from the oral surgeon, as the implant frame must be carefully positioned beneath the periosteum.

• Longer Healing Time: The healing time for subperiosteal implants is often longer than with traditional implants. This is due to the need for the frame to integrate with the surrounding tissue before the final restoration can be placed.

• Not Suitable for Everyone: Subperiosteal implants are not suitable for all patients. They are generally reserved for those with significant bone loss who cannot undergo other procedures like bone grafting or sinus lifts.

Conclusion

Subperiosteal implants offer a viable solution for patients who have insufficient jawbone to support traditional dental implants. They provide a stable and functional alternative for individuals who are not candidates for bone grafting or who have experienced significant bone loss. While the procedure is more complex and requires careful planning, the benefits of subperiosteal implants, including the restoration of function, comfort, and aesthetics, make them an excellent option for those who have limited bone volume. With careful consideration and proper aftercare, subperiosteal implants can provide long-lasting and reliable results for patients seeking a permanent solution to missing teeth.