Single-stage oral rehabilitation and dentofacial correction with a patient-specific subperiosteal implant: a case report

Extensive tooth loss and severe deterioration of oral health, frequently secondary to advanced periodontal disease and/or alveolar resorption, may preclude conventional implant rehabilitation and coexist with dentofacial deformities requiring orthognathic surgery. The integration of virtual planning and additive manufacturing enables the design of patient-specific subperiosteal implants (PSI) with dual function, capable of stabilizing osteotomized segments while simultaneously providing fixed prosthetic support, allowing one-stage oral rehabilitation strategies. This report describes a 32-year-old patient with severe periodontal disease, extensive tooth loss, and a Class III dentofacial deformity with laterodeviation, managed through virtual planning, orthognathic surgery, and placement of a dual-function PSI designed to act as both a fixation device and a prosthetic framework. The procedure was completed uneventfully. At 3- and 6-month follow-up, no wound dehiscence, implant exposure, or infection was observed, with a stable occlusion. Dual-function PSI may enable one-stage integration of orthognathic surgery and oral rehabilitation in selected patients, facilitating immediate loading through screw fixation anchored in regions with favorable bone availability. Additional cases and long-term follow-up are required to establish predictability and selection criteria. • Patient-specific subperiosteal implants are reliable in atrophic jaws • Orthognathic surgery corrects dentofacial deformities and occlusion • Combined PSI placement and orthognathic surgery reduce treatment time • Custom subperiosteal implants provide improved mechanical stability