3D Printed Customized Subperiosteal Implants

Advanced bone atrophy in both upper and lower jaw structures, loss of vertical dimension of occlusion (VDO), and also sinus pneumatization after tooth extraction demand functional and esthetical issue management through prosthetic rehabilitation. Notwithstanding, there are various and more common reconstruction approaches like bone augmentation, zygomatic implants, free fibula flap (FFF), and endosseous implants to provide this occlusion rehabilitation, but patients with Cawood and Howell class V to VIII (cases with severe deficiency in bone volume and restriction of ridge morphology principally when it develops to the anterior zone) have needed a more predictable treatment which first introduced through subperiosteal implants (SIs) in the early 1940s. The subperiosteal implant (SI) is a customized titanium structure that extends over the underlying bone (in both maxilla and mandible), under the periosteum. They usually contain four transmucosal portions that pass through the mucosa, into the oral cavity which will finally be connected to the definitive prosthesis (Altıparmak N, Polat S, Onat S, J Stomatol Oral Maxillofac Surg 124:101290, 2023; Nemtoi A, Covrig V, Nemtoi A, Stoica G, Vatavu R, Haba D, Zetu I, Diagnostics (Basel) 12:2531, 2022). Originally, Mommaerts et al. introduced a new generation of SIs to overcome previous challenges, named Additively Manufactured Subperiosteal Jaw Implants (AMSJIs). Regarding the abundance rate of health-limited situations such as a number of systemic diseases (like diabetes mellitus, osteoporosis with its bisphosphonate side effects, rheumatoid arthritis, and oral pathology), and disability disorders, AMSJIs could be a potential treatment to elevate these patients’ quality of life (Nemtoi A, Covrig V, Nemtoi A, Stoica G, Vatavu R, Haba D, Zetu I, Diagnostics (Basel) 12:2531, 2022; Marconcini S, Giammarinaro E, Covani U, Oral Maxillofac Surg Cases 9:100292, 2023). Presumably, the major success element of these implants is associated with their smart structure design.