Survival of Customized Subperiosteal Implants in Atrophic Maxilla

ABSTRACT Rehabilitation of edentulous patients with severe bone atrophy is challenging, as limited bone availability often precludes conventional implants. In such cases, 3D-printed customized subperiosteal prostheses offer a precise, less invasive alternative to bone grafting, though potential postoperative complications may affect treatment success. This study aimed to describe survival in patients rehabilitated with customized subperiosteal prostheses in the maxilla. A case series was conducted in patients with maxillary bone atrophy treated with customized subperiosteal prostheses and a minimum follow-up of 1 year. Patients with uncontrolled systemic comorbidities, ablative surgery, oncologic treatment, or incomplete medical records were excluded. Statistical analysis was performed using GraphPad Prism 10.5.0, applying the Shapiro–Wilk test, Spearman’s coefficient, and a significance level of p < 0.05. Eight patients were included (six women and two men) with a mean age of 63.75 ± 6.6 years (range 55–72). A total of 16 partial subperiosteal prostheses were placed in the maxilla. Three postoperative complications were recorded: two cases of vestibular exposure of the framework and one case of a closed oroantral fistula. The female sex was significantly associated with a higher frequency of postoperative complications (p = 0.003), whereas no significant differences were found regarding age (p = 0.8). The mean follow-up period was 20.12 ± 10.0 months, and patient satisfaction, as measured by the Visual Analog Scale (VAS), was 8.4 ± 1.3. Mucosal grafts were performed to manage soft tissue exposures; however, one prosthesis was removed due to persistent exposure. No significant correlation was found between the occurrence of complications and prosthesis removal (p = 0.2). Within the limitations of this study, customized subperiosteal prostheses demonstrated favorable stability and high patient satisfaction, with a low incidence of complications during follow-up.