Customized Subperiosteal Implant Rehabilitation Performed 14 Years After Maxillary Resection for Aggressive Fibromatosis

ABSTRACT Background: This case report presents the rehabilitation of a post-tumor resection atrophic maxillary defect using a customized subperiosteal implant. Objectives: To present the prosthetic rehabilitation of a patient with severe maxillary atrophy following resection of aggressive fibromatosis, using a customized subperiosteal implant after long term oncologic remission. Materials and Methods: A 30-year-old male underwent resection and radiotherapy for an aggressive fibromatosis lesion in the left posterior maxilla. Fourteen years later, he presented for oral rehabilitation. Clinical and radiological examinations confirmed oncologic stability but revealed inadequate bone height for endosseous or zygomatic implants. A custom subperiosteal implant was digitally planned using CBCT data and fabricated from grade 5 titanium. It was surgically placed with rigid fixation to the maxillary buttresses, supported by Bichat’s fat pad and PRF to enhance soft tissue coverage. Prosthetic rehabilitation followed after uneventful healing. Results: At the one-year follow-up, the implant maintained stable fixation, with healthy peri-implant soft tissues and no signs of complication or recurrence. The patient reported high satisfaction with both functional and aesthetic outcomes. Conclusion: Customized subperiosteal implants offer a viable and effective solution for complex maxillary defects where conventional implant techniques are contraindicated. This case supports their use in long-term oncologic survivors with severe bone atrophy.