Subperiosteal Implant Application in Full-Jaw Reconstruction for Severely Atrophic Ridge: A Case Report.

BACKGROUND

In cases of severe jaw atrophy, conventional implant-supported prosthetic rehabilitation is often limited by insufficient bone volume and the need for extensive grafting procedures. These challenges can restrict prosthetic design and compromise functional outcomes. Customized subperiosteal implants, designed to fit directly over the existing bone surface, offer an alternative approach that enables full-arch prosthetic reconstruction without bone augmentation.

METHODS

A patient with severe maxillary and mandibular atrophy underwent full-arch rehabilitation using a customized subperiosteal implant fabricated through CAD/CAM technology based on three-dimensional imaging. Although the implant framework was digitally designed, the prosthetic phase utilized conventional impression techniques to accurately capture soft tissue and abutment details. The definitive prosthesis was fabricated using a traditional laboratory workflow focusing on optimal occlusion, esthetics, and patient comfort. A structured clinical timeline, detailed surgical protocol, and short-term clinical and radiographic follow-up were documented to ensure reproducibility and objective outcome assessment.

RESULTS

The customized subperiosteal framework provided stable support for the final prosthesis. Conventional impression methods allowed precise adaptation of the restoration, minimal chairside adjustment, and satisfactory esthetic and functional outcomes. At 6-month follow-up, no implant mobility, soft-tissue exposure, infection, or prosthetic complications were observed. Clinical examination demonstrated healthy peri-implant soft tissue and stable radiographic findings. The patient reported high satisfaction with mastication, speech, and comfort.

CONCLUSION

Customized subperiosteal implants, even when combined with conventional prosthetic techniques, can reliably support full-arch restorations in patients with severely resorbed jaws. This approach merges digital surgical design with traditional prosthodontic principles, providing predictable, efficient, and patient-centered rehabilitation when conventional implant placement is not feasible. Interdisciplinary planning and strict quality-control protocols are essential to prevent design errors and optimize outcomes.