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El-Sawy MA, Hegazy SA. Subperiosteal implants constructed with digital technology: A systematic review. Oral Maxillofac Surg 2024; 28:1063-1075. [PMID: 38642167 DOI: 10.1007/s10006-024-01249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/29/2024] [Indexed: 04/22/2024]
Abstract
STATEMENT OF PROBLEM Atrophied jaw is a condition where there is insufficient bone quantity and quality. Several treatment plans are available for treating atrophied jaws, including subperiosteal implants. PURPOSE To evaluate the spectrum of subperiosteal implants for severely atrophied jaws using digital technology. MATERIALS AND METHODS An electronic and manual search was conducted in the PubMed, Scopus, and Google Scholar databases. Publications of cohort studies, case series, and case reports written in English without data restrictions that reported on subperiosteal implant management of patients with severely atrophied jaws in a completely and partially edentulous population. RESULTS A total of 26 articles, comprising 302 cases, were analyzed. In patients with severely atrophied jaws. The success rate was 87.7%, the surviving rate was 95.3%. The most common complications were biological, such as dehiscence and framework exposure. The rates of biologic complications were 11.5%, and the rates of prosthetic problems were 5.9%. CONCLUSIONS Subperiosteal implants designed and constructed using digital technology are a promising treatment in the short term. Attention should be directed to decrease the biological complication. Correct designing, implanting, fixing, and patient selection and maintenance are critical for the success of the treatment. Longer prospective studies with larger population are needed to view the effect on hard and soft tissue.
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Lee KC, Frias V, Ozturk C, Best DL, Markiewicz MR. Bimaxillary Immediate Prosthetic Rehabilitation Using a Custom Maxillary Subperiosteal Implant and Fibula-Free Flap Mandibular Reconstruction After Tumor Ablation. J Craniofac Surg 2024:00001665-990000000-01367. [PMID: 38376146 DOI: 10.1097/scs.0000000000010042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024] Open
Abstract
Subperiosteal implants (SPIs) using rigid fixation have recently emerged as an acceptable alternative to conventional endosteal implants when there is limited or absent alveolar bone. Modern advances in digital technology and manufacturing have improved the usability and stability of this latest generation of SPIs. Herein, we present the first reported case of a modern patient-specific SPI placed in the United States and, to the authors' knowledge, the first reported case performed in conjunction with a simultaneous free flap reconstruction of the opposing arch, and immediate dental rehabilitation of both arches in the world.
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Affiliation(s)
- Kevin C Lee
- Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY
- Department of Oral and Maxillofacial Surgery, University at Buffalo, Buffalo, NY
| | - Vladimir Frias
- Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Can Ozturk
- Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY
- Department of Surgery, Division of Plastic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - David L Best
- Department of Oral and Maxillofacial Surgery, University at Buffalo, Buffalo, NY
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, University at Buffalo, Buffalo, NY
- Department of Head and Neck/Plastic and Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, Buffalo, NY
- Department of Neurosurgery, Division of Pediatric Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY
- Department of Pediatric Craniomaxillofacial Surgery, Craniofacial Center of Western New York, John Oishei Children's Hospital, Roswell Park Comprehensive Cancer Center, Buffalo, NY
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Anitua E, Eguia A, Staudigl C, Alkhraisat MH. Clinical performance of additively manufactured subperiosteal implants: a systematic review. Int J Implant Dent 2024; 10:4. [PMID: 38315326 PMCID: PMC10844163 DOI: 10.1186/s40729-024-00521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
PURPOSE The aim of this study was to assess implant survival and complications rate of modern subperiosteal implants (CAD designed and additively manufactured). METHODS A systematic review was conducted using three electronic databases; Medline (Pubmed), Cochrane library, and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: "In patients with bone atrophy (P), do additively manufactured subperiosteal implants (I), compared to subperiosteal implants manufactured following traditional approaches (c), present satisfactory implant survival and complication rates (O)? The study was pre-registered in PROSPERO (CRD42023424211). Included articles quality was assessed using the "NIH quality assessment tools". RESULTS Thirteen articles were finally selected (5 cohort studies and 8 case series), including 227 patients (121 female / 106 male; weighted mean age 62.4 years) and 227 implants. After a weighted mean follow-up time of 21.4 months, 97.8% of implants were in function (5 failures reported), 58 implants (25.6%) presented partial exposure, 12 patients (5.3%) suffered soft tissue or persistent infection. Fracture of the interim prosthesis was reported in 8 of the155 patients (5.2%) in which the use of a provisional prosthesis was reported. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible. CONCLUSIONS Within the limitations of this study, modern additively manufactured subperiosteal implants presented a good survival in the short-time, but a noticeable number of soft-tissue related complications were reported. Further studies are needed to assess the clinical behavior in the medium- and long-term.
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Affiliation(s)
- Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Jose Maria Cagigal Kalea, 19, 01007, Vitoria-Gasteiz, Araba, Spain.
- BTI-Biotechnology Institute, Vitoria, Spain.
| | - Asier Eguia
- University of the Basque Country UPV/EHU and University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
| | - Christoph Staudigl
- Department of Cranio-Maxillofacial Surgery, Kepler Universitätsklinikum, Linz, Austria
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Jose Maria Cagigal Kalea, 19, 01007, Vitoria-Gasteiz, Araba, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
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Herce-López J, Pingarrón MDC, Tofé-Povedano Á, García-Arana L, Espino-Segura-Illa M, Sieira-Gil R, Rodado-Alonso C, Sánchez-Torres A, Figueiredo R. Customized Subperiosteal Implants for the Rehabilitation of Atrophic Jaws: A Consensus Report and Literature Review. Biomimetics (Basel) 2024; 9:61. [PMID: 38275459 PMCID: PMC10812919 DOI: 10.3390/biomimetics9010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: The aim was to perform a literature review on customized subperiosteal implants (CSIs) and provide clinical guidelines based on the results of an expert consensus meeting held in 2023. (2) Methods: A literature search was performed in Pubmed (MEDLINE) in July 2023, including case series and cohort studies with a minimum follow-up of 6 months that analyzed totally or partially edentulous patients treated with CSIs. Previously, an expert consensus meeting had been held in May 2023 to establish the most relevant clinical guidelines. (3) Results: Six papers (four case series and two retrospective cohort studies) were finally included in the review. Biological and mechanical complication rates ranged from 5.7% to 43.8% and from 6.3% to 20%, respectively. Thorough digital planning to ensure the passive fit of the CSI is mandatory to avoid implant failure. (4) Conclusions: CSIs are a promising treatment option for rehabilitating edentulous patients with atrophic jaws; they seem to have an excellent short-term survival rate, a low incidence of major complications, and less morbidity in comparison with complex bone grafting procedures. As the available data on the use of CSIs are very scarce, it is not possible to establish clinical recommendations based on scientific evidence.
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Affiliation(s)
- Javier Herce-López
- Oral and Maxillofacial Surgeon, Virgen Macarena University Hospital, 41009 Seville, Spain;
| | | | - Álvaro Tofé-Povedano
- Oral and Maxillofacial Surgeon, Puerta del Mar University Hospital, 11009 Cádiz, Spain;
| | - Laura García-Arana
- Oral and Maxillofacial Surgeon, San Francisco de Asís University Hospital, 28002 Madrid, Spain;
| | | | - Ramón Sieira-Gil
- Oral and Maxillofacial Consultant, Hospital Clínic, Universitat de Barcelona, 08036 Barcelona, Spain;
| | | | - Alba Sánchez-Torres
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
| | - Rui Figueiredo
- Professors of Oral Surgery, Faculty of Medicine and Health Sciences, Researchers at the IDIBELL Institute, University of Barcelona (Spain), 08907 Barcelona, Spain;
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Laurila M, Mäntynen P, Mauno J, Suojanen J. Prosthetic Oral Rehabilitation with CAD/CAM Suprastructures in Patients with Severe Tissue Deficits: A Case Series. Dent J (Basel) 2023; 11:289. [PMID: 38132427 PMCID: PMC10742847 DOI: 10.3390/dj11120289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
This article presents the outcomes of prosthetic oral rehabilitation using CAD/CAM telescopic bar overdentures in patients with oral cancer (n = 3), severe facial trauma (n = 2), or various syndromes (n = 1), all suffering from severe tissue deficits and requiring complex and comprehensive oral rehabilitation. The aim was to assess the durability and functionality of implant-retained prosthetic structures, ensuring easy oral hygiene and minimizing specialized follow-up needs. The data for this study were sourced from a retrospective cohort at Helsinki University Hospital. The prosthetic reconstruction encompassed the Atlantis 2in1 and the Createch removable telescopic systems. Thus, 40 implants were placed (4 to 7 per patient), with prosthetic structures in the maxilla (n = 4 patients), in the mandible (n = 1), and in both jaws (n = 1). Two patients experienced no complications, two patients had part of the acrylic resin break, and one patient experienced loosening of the bar structure. All complications associated with prosthetic structures were successfully managed, and none of the implants were lost. The follow-up time ranged from 7 to 126 months. This rehabilitation is proved to be an effective solution for patients with complex oral conditions, facilitating both functional restoration and ease of maintenance. These findings underscore the importance of individualized treatment approaches in cases of tissue deficits.
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Affiliation(s)
- Marisa Laurila
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.)
| | - Pilvi Mäntynen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.)
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland;
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Jari Mauno
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland;
| | - Juho Suojanen
- Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Lahti Central Hospital, 15850 Lahti, Finland; (M.L.)
- Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland;
- Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
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Pathak A, Dhamande MM, Sathe S, Gujjelwar S. Effectiveness, Esthetics, and Success Rate of Dental Implants in Bone-Grafted Regions of Cleft Lip and Palate Patients: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e49101. [PMID: 38125258 PMCID: PMC10731392 DOI: 10.7759/cureus.49101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Congenital clefts impair function and appearance, thus impacting a patient's social and mental health. A multidisciplinary team that can offer comprehensive treatment from infancy through maturity and beyond can successfully address these abnormalities. Dental rehabilitation is very important for these patients; these abnormalities should be identified and must be treated accordingly. Hence it is of utmost importance to know the success rate and changes in quality of life from patient satisfaction in order to plan future treatment goals when coming across such cases. The aim of this article is to determine success rate, esthetics, and patient satisfaction in implant-based oral rehabilitation in bone-grafted regions of cleft patients. Registration was carried out in PROSPERO (International Prospective Register of Systematic Review) with registration number CRD42022329861 on May 7, 2022. Medical Subject Headings (MeSH) terms such as cleft lip, cleft palate, survival rate, and dental implants were used to handpick articles via an electronic database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to compile all the data gathered from an electronic database. According to the collected data, 93.5% of the survival rate with dental implants was noted irrespective of the type of bone grafts used. Also, improvement in quality of life was achieved in these patients. Effectiveness, esthetics, and success rate are very well achievable with implants in cleft patients. Although the aesthetics are not equivalent to that of dental implants in normal patients, patient satisfaction is still satisfactory in patients with dental implants in bone-grafted regions of cleft lip and palate.
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Affiliation(s)
- Ankita Pathak
- Prosthodontics and Crown & Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mithilesh M Dhamande
- Prosthodontics and Crown & Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Seema Sathe
- Prosthodontics and Crown & Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Smruti Gujjelwar
- Prosthodontics and Crown & Bridge, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Rico ÁMS, Fernández ABM, Martínez EB, López AJE, Valadés RF, Plaza AM. Prosthetic restoration with virtual planned subperiosteal implant in adult patient with cleft lip and palate with severe sequelae. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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