Treatment of Seven Severely Atrophic Maxillary Full-Arch Cases Using Digitally Planned and Produced Immediately Loaded Screw-Retained Subperiosteal Implants: A Case Series with Surgical and Initial Prosthetic Outcomes.

Abstract

The volume and morphology of alveolar bone govern 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 the pyriform rim, nasal, pterygoid, and zygomatic bones have also been developed to treat these challenging cases. However, 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 restoration options when conventional treatments are contraindicated or fail. Although this new treatment has only recently been approved by the U.S. Food and Drug Administration, it has been used successfully in Europe for over 10 years with overdenture final prostheses. This case series reports on the full-arch treatment of seven patients with severely atrophic maxillae with digitally planned and milled rigidly fixated subperiosteal implants using an immediate loading protocol with fixed provisional and definitive restorations.