The rehabilitation of the atrophic posterior maxilla with a custom-made subperiosteal implant in a patient with a history of medications related to osteonecrosis of the jaws: One-year case report

Abstract

The present report describes the rehabilitation of partial edentulism (Kennedy's class II) in an elderly woman presenting with severe atrophy of the posterior maxilla, preventing standard implant placement. The woman had a positive history for osteoporosis and ongoing oral bisphosphonates therapy, thus, bone regeneration procedures, such as sinus lifting, were ruled out from the available options for her. Plus, the woman desired immediate fixed rehabilitation, thus, a 3D-printed custom subperiosteal implant was planned. The entire process, from impression acquisition to implant production was implemented in a digital setting and completed in three weeks. The surgeon was in charge of designing general implant features and the number, size, and position of future abutments. At surgery, the implant showed excellent fit and stability. One year after loading, the implant showed perfect integration and no complication could be recorded. Custom subperiosteal implants might represent a valid alternative for the rehabilitation of severely resorbed maxilla in elderly patients who cannot or do not want to undergo bone regeneration procedures. Further studies with large sample size and longer follow-up are recommended.