Subperiosteal Customized Implant On Atrophic Maxilla

When the patient does not have enough bone volume for the insertion of a regular endosteal implant, creating a successfull treatment plans becomes a challenge. One of the applicable solutions is to create a customized implant anchored on the top of the residual bone throug means of osteosynthesis screws, better know as Subperiosteal Implant.
In this case the patient comes to our attention with a drastic situation on the upper jaw which we solved by creating digitally a grid on top of the bone.
In the first session, We took a CBCT of the patient, wearing a radiological template. Then the technician, working digitally on the virtual model, was able to create the virtual framework of the custom-made implant, drawing the shape of the abutments and the lateral and crestal mashes, keeping in mind all the anatomical details. After confirming some adjustement, the titanimum custumized framework has been realized through laser synthering. The project has been finished with a Temporary PMMA Prosthesis to be fixed directly after surgery. A Resin copy of the subperiosteal implant structure has been printed to verify the precision of the bone site preparation and a guided surgical template has been prepared. We opened a full thickness crestal flap with two deep released incisions, we placed the surgical guide and prepare the crestal site. Checking the adaptation of the custom implant, we fixed it with the dedicated retaining screws. The flaps have been sutured with a good traction. Healing after 2 weeks is shown in pictures and healing after 3 months shows an optimal soft tissue remodeling and a good aesthetic result.