Subperiosteal
implants represent an alternative implant approach
for cases with severe bone atrophy. Although some successful clinical
cases have been reported, the biomechanical stability of subperiosteal
implants remains unclear, and more data are needed to confirm the
feasibility of this approach. Therefore, this study investigated the
biomechanical characteristics of subperiosteal implants based on histological
observation, clinical cases, and finite element analysis. Finite element
analysis indicated that subperiosteal implants with a lattice-like
structure could better disperse the stress to the underlying bone
surface. A novel customized subperiosteal implant was then digitally
designed and fabricated using an additive manufacturing technology.
Six beagle dogs received such customized subperiosteal implants. Histological
and microcomputed tomography examination showed new bone growth into
and around the implant. Patient-specific subperiosteal implants were
placed into the edentulous mandibular bone, with immediate loading.
The implant was functional, without pain or infection, over a 12 month
observation period. Images taken 12 months post-operatively showed
new bone formation and osseointegration of the device. This indicated
that 3D-printed lattice-like subperiosteal implants have sufficient
stability for the rehabilitation of severely atrophic ridges.