Virtual surgical planning and customized subperiosteal implants: a systematic review

Area of Science:

• Dental Implantology
• Biomaterials Engineering
• Digital Dentistry

Background:

• Subperiosteal implants (SPIs) offer solutions for severe jaw atrophy.
• Digital workflows enhance implant manufacturing precision.
• Evaluating the clinical outcomes of digitally produced SPIs is crucial.

Purpose of the Study:

• To systematically review the indications, performance, osseointegration, and safety of digitally manufactured SPIs.
• To categorize and analyze early and late biological and mechanical complications.
• To assess the viability of SPIs in patients with severely atrophic jaws.

Main Methods:

• Systematic review of PubMed and Embase databases (2018-2023) following PRISMA guidelines.
• Quality assessment using JBI and NIH tools.
• Analysis of 24 articles reporting on 246 subperiosteal implants.

Main Results:

• High implant functionality (97.6%) and survival rates (94.1-100%) after a mean 17-month follow-up.
• Common early complications: pain (25%) and swelling (24%). Infrequent late complications and implant removal (5 failures).
• Partial implant exposure noted in 37%; positive reports on success, satisfaction, and aesthetics, though infrequent.

Conclusions:

• Digitally manufactured SPIs are a viable treatment option for severely atrophic jaws, particularly in elderly or medically compromised patients.
• Further research with larger cohorts and longer follow-up periods is necessary to confirm long-term safety and efficacy.
• No single method for enhancing osseointegration demonstrated clear superiority.