What We Have Learned in the Treatment of Seven Severely Atrophic Maxillary Full-Arch Immediate-Load Protocol Patient Cases Treated with a Digitally Planned and Produced Screw-Retained Subperiosteal Implant, a Case Series with Surgical and Initial Prosthetic Outcomes.

The volume and morphology of alveolar bone drives the rehabilitation of edentulous patients. Rehabilitation of the atrophic ridge remains a challenge, both surgically and prosthetically. Commonly, bone grafting procedures, in combination with endosseous dental implants, are necessary. Graftless options, using tilted and/or longer endosseous dental implants placed into pyriform rim, nasal, pterygoid, and zygomatic bone have been developed to treat these problem cases. These options are technique sensitive and can result in increased patient morbidity. Digitally planned, custom milled, and rigidly fixated subperiosteal implants offer removable or immediate fixed options when conventional treatments are contraindicated or fail. Although this new treatment has recently been Food and Drug Administration (FDA) approved, it has been used successfully in Europe for over 10 years with overdenture final prostheses. This case series reports on the treatment of seven severely atrophic maxillae treated with a digitally planned and milled, rigidly fixated subperiosteal implant, restored with a full-arch immediate-load protocol with fixed provisional and definitive (final) restorations.