{"id":12623,"date":"2022-05-22T21:45:16","date_gmt":"2022-05-22T16:15:16","guid":{"rendered":"https:\/\/royalimplant.com\/blogs\/?p=12623"},"modified":"2026-07-27T10:15:09","modified_gmt":"2026-07-27T04:45:09","slug":"what-is-a-subperiosteal-dental-implant-procedure","status":"publish","type":"post","link":"https:\/\/royalimplant.com\/blogs\/what-is-a-subperiosteal-dental-implant-procedure\/","title":{"rendered":"Subperiosteal Dental Implant: Procedure, Benefits and Risks"},"content":{"rendered":"\n

A subperiosteal implant is not usually the first option for routine replacement of a single missing tooth. Modern patient-specific subperiosteal implants are mainly considered in carefully selected complex cases where conventional endosseous implants, bone augmentation or specialised alternatives may be difficult, unsuitable or undesirable. Current evidence is most developed for full-arch rehabilitation, while single-tooth and some reconstructive applications remain comparatively less established. <\/p>\n\n\n\n

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Who Is This Article For?<\/strong><\/h3>\n\n\n\n

This article is for patients with severe jawbone loss who have been told that conventional dental implants may not be possible without extensive bone grafting. It may also be helpful for patients with failed previous implants, severely resorbed jaws, post-cancer jaw defects or complex anatomical conditions who are exploring custom-made implant solutions.<\/p>\n\n\n\n

What Is a Subperiosteal Dental Implant?<\/strong><\/h3>\n\n\n\n

A subperiosteal dental implant is a customised metal framework positioned on the surface of the jawbone but beneath the gum tissue. The word \u201csubperiosteal\u201d means that the framework lies below the periosteum, which is the thin layer of tissue covering the outer surface of the bone. The framework is usually designed to follow the patient\u2019s individual jaw anatomy. It is fixed to selected areas of stable bone using small fixation screws. Prosthetic posts or connections extend through the gum so that a fixed bridge or another dental prosthesis can be attached.<\/p>\n\n\n

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Subperiosteal Implant<\/figcaption><\/figure>\n<\/div>\n\n\n

Unlike a conventional implant, the main framework is not shaped like a tooth root and is not inserted deeply into the jawbone. Its primary stability comes from its customised fit, rigid screw fixation and distribution of forces across stable areas of the facial skeleton. <\/p>\n\n\n\n

What Is a Modern Patient-Specific Subperiosteal Implant?<\/strong><\/h3>\n\n\n\n

Older subperiosteal implants were made using physical impressions of the exposed jawbone and cast metal frameworks. They frequently developed poor fit, movement, infection, soft-tissue breakdown, bone resorption and eventual failure. As predictable endosseous titanium implants became available, traditional subperiosteal implants were largely abandoned.<\/p>\n\n\n\n

Modern patient-specific subperiosteal implants are different. A three-dimensional scan of the jaw is used to design a customised framework digitally. The framework is then generally manufactured from titanium using CAD-CAM and additive-manufacturing technology. Modern treatment may combine CBCT imaging, digital impressions, virtual prosthetic planning, customised fixation points and 3D manufacturing. These developments have renewed interest in subperiosteal implants, but the available clinical evidence remains heterogeneous and long-term comparative studies are still limited.\u00a0<\/p>\n\n\n\n

How is Subperiosteal dental implant\u00a0placed?<\/strong><\/h3>\n\n\n\n

The subperiosteal dental implant procedure is done using a tiny incision, with or without the use of anaesthesia. First, the gum tissue is cut open to expose the bone. The surgeon then makes a small hole in the bone to place the implant. Once the implant is placed, the hole is covered with gum tissue to form a seal. There are two ways to place a subperiosteal dental implant – through drilling or by using a special device.<\/p>\n\n\n\n

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How Is the Custom Framework Manufactured?<\/strong><\/h3>\n\n\n\n

The digital design is sent to an authorised manufacturing facility. Contemporary frameworks are commonly produced from titanium or titanium alloy using additive-manufacturing or other CAD-CAM techniques. The finished framework must meet the intended design, dimensions and fixation requirements. Its fit may be assessed using physical models, digital verification and clinical evaluation during surgery. The process should not be confused with casually printing an implant inside a dental clinic. The device is a customised implantable medical component and requires appropriate design controls, material traceability, sterilisation and documentation.<\/p>\n\n\n\n

Benefits: Subperiosteal Dental Implant Procedure<\/strong><\/h3>\n\n\n\n

The primary benefit of the subperiosteal dental implant procedure is the reduced incision size. This means less visible scarring and a faster healing process. This makes it a good option for those who want to get dental implants but don\u2019t want a long-term scar on their gums. The subperiosteal implant procedure is also less painful than the traditional implant because you don\u2019t have to cut as much tissue. The subperiosteal dental implant procedure is also better suited for patients who have a weakened jaw bone and poor bone quality, as it doesn\u2019t stress the bone as much as the traditional does.<\/p>\n\n\n\n

How Is It Different From a Conventional Dental Implant?<\/strong><\/strong><\/h3>\n\n\n\n

A conventional endosseous dental implant is inserted into the jawbone and usually has a screw, cylindrical or tapered form. It replaces the root of a missing tooth and gains biological stability as the surrounding bone heals around its surface.<\/p>\n\n\n\n

A subperiosteal implant does not use an individual root-shaped fixture in the same way. A customised framework rests over selected areas of the bone and is secured with multiple fixation screws. Prosthetic connections extend from the framework through the gum.<\/p>\n\n\n\n

Conventional implants generally have a much larger body of long-term scientific evidence and remain the standard approach when sufficient bone and favourable anatomy are available. A subperiosteal implant is a specialised alternative for selected patients rather than a routine replacement for conventional implants.<\/p>\n\n\n\n

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Subperiosteal Implant<\/figcaption><\/figure>\n\n\n\n
\"Single<\/figure>\n<\/figure>\n\n\n\n

The subperiosteal dental implant procedure is best for patients who want to avoid visible scarring and have good bone quantity and quality. Those who have poor bone quality or thin gum tissue may not be good candidates for the subperiosteal implant procedure. The traditional procedure is also a good option for patients who have good bone quality, but it is not suitable for those who have poor bone quantity or thin gum tissue. This is because a larger incision is required to place the dental implant.<\/p>\n\n\n\n

Who May Be Considered for a Subperiosteal Implant?<\/strong><\/h3>\n\n\n\n
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  1. A patient-specific subperiosteal implant may be considered for a person with severe upper- or lower-jaw atrophy where conventional implants cannot be placed in prosthetically useful positions without major augmentation.<\/li>\n\n\n\n
  2. It may also be considered after failure of previous implant or grafting procedures, in certain post-cancer or reconstructive defects, or when the patient is medically or personally unable to undergo several stages of bone-grafting treatment.<\/li>\n\n\n\n
  3. The decision depends on the remaining basal bone, soft-tissue condition, proposed fixation areas, bite, prosthetic space, medical history and the patient\u2019s ability to clean and maintain the final prosthesis.<\/li>\n\n\n\n
  4. Modern reviews emphasise that these implants should remain highly selective, prosthetically planned and supported by careful soft-tissue management and structured long-term maintenance.\u00a0<\/li>\n<\/ol>\n\n\n\n

    Drawbacks of Subperiosteal dental implant\u00a0Procedure<\/strong><\/h3>\n\n\n\n

    The subperiosteal dental implant procedure is more expensive than the traditional procedure because it requires expensive tools and a longer surgery time. The subperiosteal dental implant procedure is also less predictable than the traditional dental implant procedure. This is because the final position of the implant is not known until the end of the surgery, when the hole actually made in the bone. Those who get subperiosteal dental implants may not be able to have a dental bridge or dentures because the gum tissue is not exposed.<\/p>\n\n\n\n

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    A subperiosteal implant may not be appropriate when there is uncontrolled oral infection, active untreated gum disease, inadequate healthy soft tissue, poor plaque control or an inability to attend maintenance appointments. Medical conditions that interfere with surgery or healing must be assessed individually. Smoking, uncontrolled systemic disease, severe grinding and unrealistic expectations may also affect treatment planning and long-term risk. Insufficient bone in the usual implant region does not automatically make a patient suitable for a subperiosteal implant. The surgeon must identify stable anatomical areas where the framework can be fixed safely without damaging nerves, sinuses, teeth or other structures.<\/p>\n\n\n\n

    Are Subperiosteal Dental Implants Successful?<\/strong><\/h3>\n\n\n\n

    Modern custom-made subperiosteal implants have shown encouraging short-term survival in selected cases. However, no universal success rate should be promised. <\/p>\n\n\n\n

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    Many published reports involve small patient groups, different framework designs and relatively limited follow-up. An implant may remain in position while still requiring repeated treatment for exposure, inflammation or prosthetic problems.<\/p>\n<\/blockquote>\n\n\n\n

    Successful treatment should include a stable framework, healthy and maintainable soft tissue, comfortable function, an acceptable prosthesis and the absence of progressive infection or clinically significant complications.<\/p>\n\n\n\n

    What Should Patients Ask Before Treatment?<\/strong><\/h3>\n\n\n\n
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    1. Patients should ask why a subperiosteal implant is being recommended instead of conventional implants, grafting, zygomatic implants or a removable alternative.<\/li>\n\n\n\n
    2. They should also understand who will design and manufacture the framework, what material will be used, whether the first teeth are temporary or final, what happens if part of the framework becomes exposed and whether the implant can be modified or removed if complications occur.<\/li>\n\n\n\n
    3. The treatment estimate should clearly identify the imaging, customised framework, fixation screws, surgery, anaesthesia, temporary teeth, final prosthesis and future maintenance.<\/li>\n<\/ol>\n\n\n\n
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      Conclusion<\/strong><\/h3>\n\n\n\n

      A modern subperiosteal dental implant is a customised framework positioned over the jawbone and beneath the gum. It is fixed to stable bone using screws and provides prosthetic connections for supporting replacement teeth. It may offer a graftless or reduced-grafting solution for selected patients with severe jawbone loss. However, it is not placed inside the bone like a conventional implant, and the surgery should not be presented as a simple procedure involving only a tiny hole. Modern digital design and 3D manufacturing have improved the accuracy of these implants, but long-term evidence remains limited. Careful patient selection, prosthetically driven planning, soft-tissue management and lifelong maintenance are essential.<\/p>\n\n\n\n

      Frequently Asked Questions<\/strong><\/h3>\n\n\n\n

      Where is a subperiosteal implant placed?<\/strong><\/h4>\n\n\n\n

      It is positioned on the outer surface of the jawbone but beneath the gum and periosteum. It is usually fixed to the bone using multiple screws.<\/p>\n\n\n\n

      Is a subperiosteal implant placed inside the jawbone?<\/strong><\/h4>\n\n\n\n

      No. The main framework rests over the bone. Only the fixation screws enter the bone. This differs from a conventional endosseous implant, whose main body is inserted into the jawbone.<\/p>\n\n\n\n

      Can a subperiosteal implant support fixed teeth?<\/strong><\/h4>\n\n\n\n

      Yes. Prosthetic posts or connections extend through the gum and can support a fixed bridge. The existing article\u2019s statement that it cannot support a crown or bridge is incorrect.<\/p>\n\n\n\n

      Does a subperiosteal implant require bone grafting?<\/strong><\/h4>\n\n\n\n

      It is often considered to avoid extensive grafting in patients with severe bone loss. Small supplementary bone or soft-tissue procedures may still be necessary in selected cases.<\/p>\n\n\n\n

      Is a subperiosteal implant less invasive?<\/strong><\/h4>\n\n\n\n

      It may avoid major bone-grafting procedures, but placement of the framework can require broad exposure of the jawbone. It should not automatically be described as a minor or scarless procedure.<\/p>\n\n\n\n

      Can subperiosteal implants provide teeth in one day?<\/strong><\/h4>\n\n\n\n

      Immediate fixed teeth may be possible when the framework has rigid fixation and the prosthesis can control chewing forces. It is not suitable or guaranteed in every case.<\/p>\n\n\n\n

      Can a subperiosteal implant be used in the lower jaw?<\/strong><\/h4>\n\n\n\n

      Yes. Custom frameworks may be designed for severely atrophic upper or lower jaws. The anatomical risks and fixation strategy differ between the two regions.<\/p>\n\n\n\n

      Are subperiosteal implants better than zygomatic implants?<\/strong><\/h4>\n\n\n\n

      Neither is universally better. Zygomatic implants are anchored within the cheekbone and are mainly used for severe upper-jaw atrophy. Subperiosteal frameworks rest over selected bone surfaces and can be designed for different complex defects.<\/p>\n\n\n\n

      What is the most common complication?<\/strong><\/h4>\n\n\n\n

      Soft-tissue breakdown with exposure of part of the framework is among the most commonly reported complications. Infection, inflammation and mechanical or prosthetic problems may also occur. <\/p>\n\n\n\n

      Can an exposed subperiosteal implant be repaired?<\/strong><\/h4>\n\n\n\n

      Small exposures may sometimes be managed through professional cleaning, soft-tissue treatment or surgery. Persistent infection, movement or extensive exposure may require partial or complete removal.<\/p>\n\n\n\n

      Are modern subperiosteal implants the same as older designs?<\/strong><\/h4>\n\n\n\n

      No. Older implants were commonly cast from direct bone impressions and had significant fit and complication problems. Modern devices are digitally planned, customised and generally manufactured from titanium using CAD-CAM technology.\u00a0<\/p>\n\n\n\n