Patient-Specific Subperiosteal Implant for the Management of Upper Denture Retention Problems

Papenhuijzen, E.A.J.M. Schulten, D.H. J. Jager, J.P.T.F. Ho 

Full text link: https://pubmed.ncbi.nlm.nih.gov/41778337/

Patient-Specific Subperiosteal Implant for the Management of Upper Denture Retention Problems

1. Scientific Reference

• Study Title: Patient-Specific Subperiosteal Implant for the Treatment of Upper Denture Retention Problems
• Authors: F. Papenhuijzen, E.A.J.M. Schulten, D.H. J. Jager, J.P.T.F. Ho
• Journal: Nederlands Tijdschrift voor Tandheelkunde (NTVT)
• Publication Year: 2026
• DOI: 10.5177/ntvt.2026.03.25071

2. Scientific Background

Managing patients with extensive maxillary bone loss remains one of the greatest challenges in implant dentistry and oral surgery. Severe defects caused by disease or surgical resection often compromise the retention and stability of complete removable dentures, substantially affecting oral function and patient comfort. In such situations, conventional endosseous implant therapy may not be feasible because of insufficient residual bone volume.

This case report explores the use of a patient-specific subperiosteal implant designed through a fully digital workflow combining three-dimensional imaging and additive titanium manufacturing. The study illustrates an individualized reconstructive approach intended to restore prosthetic retention in a patient with a significant maxillary defect following treatment for an invasive fungal infection. It also reflects the growing role of digital planning and customized implant design in complex implant-supported rehabilitation when conventional treatment options are limited.

3. Study Objective

The primary objective of this report was to describe the clinical use of a customized subperiosteal implant to improve the retention of a complete maxillary denture in a patient with a substantial maxillary bone defect following partial maxillary resection. The authors also aimed to demonstrate the clinical feasibility of combining three-dimensional digital planning with patient-specific titanium implant manufacturing for complex prosthetic rehabilitation.

4. Methodology

This publication is a single-patient clinical case report involving a 66-year-old man.

Computed tomography (CT) imaging was used to generate a three-dimensional model of the remaining maxillary bone, allowing the design of a customized subperiosteal implant. The implant was manufactured from titanium using selective laser melting technology and surgically fixed to the residual maxillary bone with titanium screws under general anesthesia. The definitive removable prosthesis was delivered six weeks after surgery.

Clinical follow-up extended to two years. The abstract does not specify detailed clinical outcome measures, assessment criteria, or additional methodological parameters.

5. Main Findings

According to the authors, the customized subperiosteal implant remained clinically functional throughout the two-year follow-up period. The implant successfully provided adequate support for the maxillary denture, resulting in satisfactory prosthetic function. The patient also reported a high level of satisfaction with the treatment outcome.

The case demonstrates that a patient-specific subperiosteal implant can restore denture retention in the presence of a significant maxillary defect following pathological bone loss. The authors suggest that the latest generation of customized subperiosteal implants may represent a viable treatment option for patients with jaw defects resulting from disease or severe physiological alveolar bone resorption.

No quantitative success rates, biological or mechanical complication rates, implant survival data, or additional clinical outcome measures are reported in the available abstract.

6. Clinical Analysis

This case highlights the potential contribution of digital implant workflows to the rehabilitation of patients presenting with severe maxillary anatomical deficiencies. By tailoring the implant to the patient’s remaining bone anatomy, the customized subperiosteal design offers an alternative reconstructive strategy when conventional endosseous implants may not be suitable because of insufficient bone support.

The report also illustrates how modern technologies—including CT-based planning, three-dimensional design, and additive titanium manufacturing—can be integrated into personalized implant reconstruction. Such an approach may help restore prosthetic stability in carefully selected patients with extensive maxillary defects following pathological conditions requiring surgical resection.

However, the clinical significance of these findings should be interpreted cautiously. The evidence is based on a single clinical case without a comparison group, preventing conclusions regarding reproducibility, long-term predictability, or superiority over other reconstructive approaches. Consequently, this publication should be viewed primarily as a demonstration of clinical feasibility rather than definitive evidence supporting routine clinical use. The abstract also provides limited information regarding biological outcomes, prosthetic maintenance, or long-term implant performance beyond the reported follow-up period.

7. Clinical Applications

Based on the information provided, this treatment approach may be relevant for carefully selected patients presenting with:

• Extensive maxillary bone defects following pathological conditions requiring surgical resection.
• Poor retention of complete maxillary dentures due to insufficient residual bone.
• Clinical situations where patient-specific digital implant planning is appropriate.
• Complex implant rehabilitation protocols incorporating CAD/CAM design and additive titanium manufacturing.

The available abstract does not provide sufficient evidence to recommend this technique for broader clinical indications or to compare it with alternative reconstructive procedures.

8. Level of Evidence, Limitations, and Transparency

This publication represents a clinical case report, corresponding to a low level of scientific evidence.

Its principal methodological limitation is the inclusion of only one patient without a control group or comparative treatment. Although the reported follow-up reached two years, the available data remain insufficient to establish long-term predictability or generalize the observed outcomes.

No information regarding conflicts of interest, industry affiliations, or funding sources is provided in the available abstract.

Accordingly, the findings should be interpreted as an encouraging clinical demonstration rather than definitive evidence supporting widespread implementation of patient-specific subperiosteal implants.

9. Key Study Points

• Study type: Clinical case report.
• Level of evidence: Low.
• Study population: One patient.
• Number of patients: 1.
• Follow-up duration: 2 years.
• Primary outcome evaluated: Functional performance of a patient-specific subperiosteal implant supporting a maxillary complete denture.
• Main finding: The implant and prosthesis remained functional throughout follow-up, with high patient satisfaction.
• Scientific conclusion: This case suggests that customized subperiosteal implants may provide a treatment option for selected patients with severe maxillary bone defects.
• Main limitations: Single-patient report, absence of a control group, and limited methodological detail.

10. Scientific Impact

This publication contributes to the growing body of literature describing the renewed use of customized subperiosteal implants enabled by digital planning technologies and additive manufacturing. Rather than introducing comparative clinical evidence, it demonstrates how individualized implant design may expand reconstructive possibilities for patients with severe maxillary deficiencies who have limited conventional treatment options.

From a scientific perspective, the report primarily provides proof of clinical feasibility. While its findings cannot be generalized because of the low level of evidence, it supports continued investigation into patient-specific implant rehabilitation and highlights the potential role of personalized digital workflows in complex oral and maxillofacial reconstruction. Larger clinical studies will be necessary to better define indications, long-term outcomes, and comparative effectiveness.

11. Editorial Conclusion

This clinical case report illustrates the potential of patient-specific subperiosteal implants manufactured through a fully digital workflow to improve prosthetic retention in a patient with a substantial maxillary defect following mucormycosis. The favorable two-year clinical outcome is encouraging, but its interpretation should remain cautious given the limited level of evidence. Overall, the study highlights the evolving role of customized implant design in managing highly complex implant rehabilitation cases while emphasizing the need for further clinical research.