Edentulous patients not amenable to dental implants due to a severely atrophic ridge may not have suitably retentive dental prostheses. Subperiosteal dental implants, once discarded as a viable treatment option due to postoperative infection and subsequent failure, have become a viable treatment option once again due to newer surgical techniques, technology, and biomaterials. A 54-year-old male presented with a chief complaint of an ill-fitting maxillary complete denture and inability to masticate efficiently. Clinical and radiographic examination revealed severe atrophy of the maxilla with pneumatized sinuses and was not a candidate for traditional dental implants or bone augmentation. A new maxillary complete denture was fabricated and used as a scan appliance and fixed prosthesis template to design a subperiosteal implant. A cone beam computed tomography (CBCT) scan and Digital Imaging and Communications in Medicine (DICOM) file were obtained and the information was sent to KLS-Martin (Tuttlingen, Germany) for virtual planning. Once approved by the surgical and restorative teams, the titanium subperiosteal implant and prosthesis prototype were fabricated and delivered under general anesthesia. After 6 months of wearing the PMMA prototype, a definitive zirconia prosthesis was delivered.
Wilkins et al. (Fri,) studied this question.