Radiographic Evaluation of Bone Remodeling after Additively Manufactured Subperiosteal Jaw Implantation (AMSJI) in the Maxilla: A One-Year Follow-Up Study

Abstract

Additively manufactured subperiosteal jaw implants (AMSJI) are patient-specific, 3D-printed, titanium implants that provide an alternative solution for patients with severe maxillary bone atrophy. The aim of this study was to evaluate the bony remodeling of the maxillary crest and supporting bone using AMSJI. Fifteen patients with a Cawood–Howell Class V or greater degree of maxillary atrophy were evaluated using (cone beam) computed tomography scans at set intervals: one month (T1) and twelve months (T2) after definitive masticatory loading of bilateral AMSJI implants in the maxilla. The postoperative images were segmented and superimposed on the preoperative images. Fixed evaluation points were determined in advance, and surface comparison was carried out to calculate and visualize the effects of AMSJITM on the surrounding bone. A total mean negative bone remodeling of 0.26 mm (SD 0.65 mm) was seen over six reference points on the crest. Minor bone loss (mean 0.088 mm resorption, SD 0.29 mm) was seen at the supporting bone at the wings and basal frame. We conclude that reconstruction of the severely atrophic maxilla with the AMSJI results in minimal effect on supporting bone. Reduced stress shielding with a biomechanically tuned subperiosteal implant does not induce radiographically significant crestal bone atrophy.

A New Strategy for Patient-Specific Implant-Borne Dental Rehabilitation in Patients With Extended Maxillary Defects

“…With regard to the quality of life, initial data show that restoration with patient-specific implants achieves outcomes that are comparable or even superior to those of conventional implants (22). This treatment option appears at first glance to be similar to the previously used subperiosteal implants, that were abandoned due to high complication rates (23). However, this is not true because the multivectorial and distant fixation of the implant using the midfacial buttresses or even the lateral skull base in selected cases fundamentally differs as an average of 22 screws achieves primary stability and allows full and immediate loading.…”

Prosthodontic rehabilitation of patients with a unilateral subtotal maxillectomy using a customised subperiosteal zygomatic implant: a post-COVID-19 mucormycosis

“…Furthermore, the molar or premolar region—rather than the aesthetic zone—is the only place where the implant shoulder of zygomatic implants may be positioned. For every patient, a subperiosteal implant is designed with a high degree of precision 31. Thus, the idea of a subperiosteal implant that is ‘high-tech’ has been revived.…”

Virtual Surgical Planning and Customized Subperiosteal Titanium Maxillary Implant (CSTMI) for Three Dimensional Reconstruction and Dental Implants of Maxillary Defects after Oncological Resection: Case Series

“…In recent years, the advent of titanium 3D printing and 3D planning software have made reconsideration of the subperiosteal implant concept possible. The design of a subperiosteal implant is performed with a high degree of accuracy for each patient [ 17 ]. Thus, the concept of a ‘high-tech’ subperiosteal implant has been reborn.…”

“…Minor atrophy was seen at the alveolar ridge, but minimal atrophy was detected under the fixation wing. Patients showed a mean resorption at the alveolar ridge of 0.33 mm (SD 0.76 mm) and 0.08 (SD 0.33) mm at the wings and basal frame on the underlying zygo-maxillary bone one year post loading [ 17 ].…”

“…However, its efficiency still needs to be proven in the long term. Several reviews have, however, also reported on complications such as infections, early and late implant exposure, bone resorption, fistulation and implant mobility, leading to implant failure [ 17 ]. Prospective and more extensive studies are needed to assess its efficiency and safety and draw more conclusions.…”