Subperiosteal Implant: Definition, Benefits, and Modern Use in Dentistry

When it comes to dental implants, most people are familiar with traditional endosteal implants that are placed directly into the jawbone. However, there is another type of implant known as the subperiosteal implant, which was historically used for patients with insufficient bone volume. Although less common today, it still holds relevance in certain clinical cases.

What Is a Subperiosteal Implant?

A subperiosteal implant is a custom-made metal framework designed to rest on top of the jawbone but underneath the gum tissue. Unlike endosteal implants, which require healthy bone density for placement, subperiosteal implants are positioned beneath the periosteum (the thin tissue covering the bone) and anchored with posts that protrude through the gums to support artificial teeth.

When Are Subperiosteal Implants Used?

Subperiosteal implants were developed as an alternative for patients who lacked adequate bone height or density for conventional implants. They are typically considered in situations such as:

• Severe bone resorption where bone grafting is not possible or not preferred.

• Patients who want to avoid complex bone augmentation surgeries.

• Cases where traditional endosteal implants would have a high failure risk.

Advantages of Subperiosteal Implants

• Bone grafting not required – suitable for patients with advanced bone loss.

• Immediate prosthetic support – allows for quicker restoration in some cases.

• Custom design – the framework is tailored to fit the patient’s bone anatomy.

Disadvantages and Limitations

Despite their unique benefits, subperiosteal implants are used less frequently today because:

• Higher risk of infection and implant failure compared to modern alternatives.

• Complex surgical procedure that requires precise customization.

• Lower long-term success rates than endosteal implants.

Subperiosteal vs. Endosteal Implants

• Endosteal Implants: Placed directly into the jawbone; most widely used today due to higher success rates and biocompatibility with bone grafting options.

• Subperiosteal Implants: Placed on top of the jawbone; useful for patients with minimal bone but rarely the first choice today.

Conclusion

The subperiosteal implant was once a popular solution for patients with insufficient bone structure, offering a way to restore missing teeth without bone grafting. However, with advancements in modern dentistry, endosteal implants supported by bone grafting or zygomatic implants are now preferred due to their higher success rates and long-term stability.

Still, in select cases where bone grafting is not an option, subperiosteal implants may remain a valuable alternative. Consulting with a qualified oral surgeon is essential to determine the best implant type for each patient’s unique needs.