Related Experiment Video
Updated: Mar 16, 2026
3D Planning and Printing of Patient Specific Implants for Reconstruction of Bony Defects
Published on: August 4, 2020
Clinical Outcomes, Survival, and Complications of Customized Computer-Aided Design and Manufacturing
Saverio Cosola1, Ernesto Vatteroni2, Mohammadreza Asadi3
1Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, Camaiore, Italy; San Rossore Dental Unit, Casa di Cura San Rossore, Pisa, Italy.
Background:
Rehabilitation of severely atrophic jaws remains a clinical challenge. Customized CAD/CAM 3D-printed titanium subperiosteal implants have re-emerged as an alternative to extensive bone augmentation.
Purpose:
This systematic review and meta-analysis aimed to evaluate implant survival, complications, and clinical outcomes associated with modern customized subperiosteal implants.
Data Source:
Electronic searches of PubMed/Medline, Scopus, Web of Science, the Cochrane Library, and Google Scholar were conducted up to November 2025.
Study Selection:
Randomized controlled trials, cohort studies, and case series reporting outcomes of customized CAD/CAM or 3D-printed titanium subperiosteal implants were included.
Data Extraction And Synthesis:
This review followed the PRISMA guidelines and was registered in PROSPERO. A random-effects meta-analysis was performed to calculate pooled survival rates with 95% confidence intervals.
Main Outcomes:
Implant survival and complications were the primary outcomes.
Results:
Eleven studies including 268 patients and 369 implants were analyzed. Short-term implant survival was high, with a pooled survival rate of 97.8% for studies with follow-up of ≤3 years. The overall pooled survival rate was 92.4%, with substantial heterogeneity driven by long-term data. The longest follow-up study (6 years) reported a survival decline to 54.1%. Soft tissue-related complications, particularly implant exposure and dehiscence, were the most common adverse events and the main cause of late implant failure.
Conclusions And Relevance:
Customized subperiosteal implants provide predictable short-term outcomes and immediate rehabilitation in severe jaw atrophy. However, long-term performance is limited by soft tissue-related complications, and implant survival alone overestimates clinical success. These implants should be considered a salvage option for carefully selected patients.
