Pellegrino Gerardo, Karaban Maryia, Barausse Carlo, Giudice Amerigo, Antonelli Alessandro, Pistilli Roberto, Felice Pietro
Department of Biomedical and Neuromotor Sciences, University of Bologna, Via San Vitale 59, 40125 Bologna, Italy.
Department of Health Sciences of the 'Magna Graecia', University of Catanzaro, 88100 Catanzaro, Italy.
Dent J (Basel). 2025 Jul 23;13(8):337. doi: 10.3390/dj13080337.
Severe jawbone atrophy, particularly in elderly or medically compromised patients, presents a significant challenge for conventional implant placement. In cases where bone augmentation is not feasible, alternative techniques-such as short, narrow, tilted, and zygomatic implants-may be indicated for the rehabilitation of the atrophic jaw. Subperiosteal implants have re-emerged as a further viable alternative, especially with recent advancements in digital planning and custom fabrication. This study aims to evaluate the clinical outcomes and complications associated with subperiosteal implants through a literature review and a supporting case series, and to propose clinical preliminary guidelines for their use. : Fourteen studies-including case reports, case series, retrospective studies, and systematic reviews-were analyzed to assess the effectiveness and risk profile of subperiosteal implants. Additionally, we present a case series of nine patients with advanced vertical and horizontal alveolar bone atrophy treated using custom-made, digitally-designed subperiosteal implants. Surgical techniques, prosthetic workflows, and complications were recorded and assessed. : Subperiosteal implants were found to be particularly suitable for patients with narrow alveolar crests and severe atrophy where traditional implants are contraindicated. Literature and case series data indicated favorable outcomes, with early complications such as soft tissue inflammation and prosthetic misfit being manageable. A low complication rate was recorded in our series, with digital workflows contributing to improved implant fit and reduced technical errors. : Subperiosteal implants could offer an effective solution for complex atrophic cases, provided that patient selection, surgical precision, and prosthetic design are meticulously managed. Based on our findings, clinical recommendations are proposed to guide their application in contemporary practice.
严重的颌骨萎缩，尤其是在老年患者或有医学并发症的患者中，给传统种植体植入带来了重大挑战。在骨增量不可行的情况下，可能需要采用替代技术，如短种植体、窄种植体、倾斜种植体和颧骨种植体，来修复萎缩的颌骨。骨膜下种植体作为一种可行的替代方案重新出现，特别是随着数字规划和定制制造技术的最新进展。本研究旨在通过文献综述和相关病例系列评估骨膜下种植体的临床疗效和并发症，并提出其临床应用的初步指南。分析了14项研究，包括病例报告、病例系列、回顾性研究和系统评价，以评估骨膜下种植体的有效性和风险状况。此外，我们还展示了一个病例系列，包括9例使用定制的、数字化设计的骨膜下种植体治疗的垂直和水平牙槽骨严重萎缩患者。记录并评估了手术技术、修复流程和并发症。发现骨膜下种植体特别适合牙槽嵴狭窄和严重萎缩且传统种植体禁忌的患者。文献和病例系列数据显示效果良好，早期并发症如软组织炎症和修复体不贴合是可控的。我们的病例系列中并发症发生率较低，数字流程有助于提高种植体贴合度并减少技术误差。骨膜下种植体可以为复杂的萎缩病例提供有效的解决方案，前提是精心管理患者选择、手术精度和修复设计。基于我们的研究结果，提出临床建议以指导其在当代实践中的应用。
