What is a Subperiosteal Implant (Custom Implant)?
Subperiosteal implant is a custom-designed metal framework system that rests on top of the jawbone and under the gum, not inside the bone. Instead of placing a screw-shaped root inside the bone as we do in classical implants, a thin mesh or frame that conforms to the shape of the bone is used, and fixed prostheses are attached onto it.
This method is an advanced implant technique that comes into play especially for patients with advanced bone loss who lack sufficient bone volume for standard implants. That is, in many cases where it is said "no bone, no implant," the possibility of fixed teeth can re-emerge thanks to subperiosteal implants.
In short: A subperiosteal implant is an implant system that rests on top of the bone, is custom-designed for the patient's jaw, and provides a foundation for a fixed prosthesis.
Tooth loss is not just an aesthetic issue; it is a serious problem that directly affects chewing, speech, and quality of life. Although classical dental implants offer a successful solution for most patients, in cases of advanced bone resorption, one can sometimes feel helpless. It is at this very point that subperiosteal implants, which are placed on top of the bone rather than inside it, come into play. Especially for patients who are told "implants are not suitable for you" due to bone insufficiency, subperiosteal implants offer a modern and fixed alternative.
Subperiosteal implants are particularly considered for the following patient groups:
Patients with advanced bone loss who do not want or are not suitable for bone augmentation surgery (graft, block, sinus lift, etc.)
Patients who have used complete dentures (palate) for a long time and have severely resorbed jaws
Individuals who are elderly and have systemic diseases, seeking a shorter, single-session solution rather than long and multi-stage surgeries
Cases where multiple attempts at classical implants have been made but success was not achieved
Fully edentulous patients who say, "I don't want a palate, I want fixed teeth in my mouth," but have bone insufficiency
So in summary: subperiosteal implants come into consideration when bone insufficiency + desire for fixed prosthesis combine. The decision should be made after a good analysis of the patient's general health, expectations, and jaw anatomy.
Looking from a clinical perspective, the main indications for subperiosteal implants are:
Severely resorbed (atrophied) jaws
Insufficient bone volume for standard implants
High-risk patients with comorbidities who may not tolerate extensive bone reconstruction surgeries
Cases requiring rapid function and more minimal surgery, with time constraints
Jaws with multiple missing teeth, especially complete edentulism, where a fixed bridge is planned but classical implants cannot be placed due to bone issues
This technique is not for a "let's put subperiosteal implants in everyone" approach; it is a method developed to be a powerful alternative in selected, difficult cases.
Subperiosteal implant treatment is like a completely custom engineering process:
Examination and imaging: The jaw bone structure is analyzed through clinical examination, CBCT (tomography), and if necessary, photos / scans.
Digital planning and design: The bone surface is modeled in 3D, and the implant framework is designed using CAD/CAM to fit the patient's anatomy perfectly.
The gum is lifted, the designed bone-on implant framework is seated on the bone and fixed.
The gum is closed again and sutured.
Healing and prosthesis: After a short healing period, fixed prostheses are prepared on the connections on the subperiosteal implant and placed in the mouth.
The most critical point in this process is correct planning and correct case selection.
Offering the possibility of fixed teeth even with bone insufficiency
In most cases, not requiring extra augmentations like bone grafts or sinus lifts
The surgical intervention being shorter and more minimal compared to advanced reconstructive surgeries
The healing process being relatively faster
Offering a comfortable, fixed prosthesis opportunity for patients who have used palatal dentures for a long time and experience speech / chewing problems
Due to the custom design, high anatomical fit to the jaw
How does a subperiosteal implant differ from classical (intraosseous) implants?
In classical (endosseous) implants, a titanium screw is placed directly inside the jawbone, aiming for osseointegration with the bone. The logic in subperiosteal implants is different:
Classical implant: Screw / cylindrical implant inside the bone.
Subperiosteal implant: A metal framework that rests on top of the bone, under the periosteum.
This difference means:
Classical implants require sufficient bone height and width; if necessary, additional surgeries like sinus lifts, bone grafts are performed. In subperiosteal implants, even if the bone volume is very low, stability is achieved with the framework that conforms to the shape of the bone.
Therefore, subperiosteal implants offer an alternative fixed prosthesis solution in cases of advanced bone resorption, in severely atrophic jaws, where classical implants are either very difficult or impossible.
In classical (endosseous) implants, a titanium screw is placed directly inside the jawbone, aiming for osseointegration with the bone. The logic in subperiosteal implants is different:
Classical implant: Screw / cylindrical implant inside the bone.
Subperiosteal implant: A metal framework that rests on top of the bone, under the periosteum.
This difference means:
Classical implants require sufficient bone height and width; if necessary, additional surgeries like sinus lifts, bone grafts are performed. In subperiosteal implants, even if the bone volume is very low, stability is achieved with the framework that conforms to the shape of the bone.
Therefore, subperiosteal implants offer an alternative fixed prosthesis solution in cases of advanced bone resorption, in severely atrophic jaws, where classical implants are either very difficult or impossible.
Who are subperiosteal implants suitable for, and in which situations are they preferred?
Subperiosteal implants are particularly considered for the following patient groups:
Patients with advanced bone loss who do not want or are not suitable for bone augmentation surgery (graft, block, sinus lift, etc.)
Patients who have used complete dentures (palate) for a long time and have severely resorbed jaws
Individuals who are elderly and have systemic diseases, seeking a shorter, single-session solution rather than long and multi-stage surgeries
Cases where multiple attempts at classical implants have been made but success was not achieved
Fully edentulous patients who say, "I don't want a palate, I want fixed teeth in my mouth," but have bone insufficiency
So in summary: subperiosteal implants come into consideration when bone insufficiency + desire for fixed prosthesis combine. The decision should be made after a good analysis of the patient's general health, expectations, and jaw anatomy.
What are the indications for subperiosteal implants?
Looking from a clinical perspective, the main indications for subperiosteal implants are:
Severely resorbed (atrophied) jaws
Insufficient bone volume for standard implants
High-risk patients with comorbidities who may not tolerate extensive bone reconstruction surgeries
Cases requiring rapid function and more minimal surgery, with time constraints
Jaws with multiple missing teeth, especially complete edentulism, where a fixed bridge is planned but classical implants cannot be placed due to bone issues
This technique is not for a "let's put subperiosteal implants in everyone" approach; it is a method developed to be a powerful alternative in selected, difficult cases.
How is subperiosteal implant treatment planned and applied?
Subperiosteal implant treatment is like a completely custom engineering process:
Examination and imaging: The jaw bone structure is analyzed through clinical examination, CBCT (tomography), and if necessary, photos / scans.
Digital planning and design: The bone surface is modeled in 3D, and the implant framework is designed using CAD/CAM to fit the patient's anatomy perfectly.
Surgical stage:
Local anesthesia (sedation / general anesthesia if necessary) is applied.The gum is lifted, the designed bone-on implant framework is seated on the bone and fixed.
The gum is closed again and sutured.
Healing and prosthesis: After a short healing period, fixed prostheses are prepared on the connections on the subperiosteal implant and placed in the mouth.
The most critical point in this process is correct planning and correct case selection.
What are the advantages of subperiosteal implants?
The prominent advantages of subperiosteal implants are:Offering the possibility of fixed teeth even with bone insufficiency
In most cases, not requiring extra augmentations like bone grafts or sinus lifts
The surgical intervention being shorter and more minimal compared to advanced reconstructive surgeries
The healing process being relatively faster
Offering a comfortable, fixed prosthesis opportunity for patients who have used palatal dentures for a long time and experience speech / chewing problems
Due to the custom design, high anatomical fit to the jaw
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- What Is A Dental Implant? Who Is It For And How Long Does It Take?
- Immedıate Implant Treatment In 1 Day
- All On Sıx Dental Implant Treatment
- What İs A Single Tooth İmplant?
- All-on-four Implant Treatment
- Implant Treatment Under General Anesthesıa
- Implant-supported Brıdge Treatment
- Why Do Dental Implants Faıl? Perı-ımplantıtıs Treatment
- Implant Placement Wıth Bone Graft
- Short Implants
- Guided Implant Surgery Treatment
- Sinus Lift Treatment
- Custom Subperıosteal Implant Treatment
- Implant Placement Wıth Ilıac Graft
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