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The atrophic edentulous alveolus. A preliminary study on a new generation of subperiosteal implants

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Abstract

The aim of this cohort case series is to present a new subperiosteal implant device that uses CAD-CAM technologies together with 3D metal printing capabilities to produce direct bone-anchored dental prosthetic solutions for the management of atrophic edentulous alveolus and jaws. The clinical experience of 21 subperiosteal devices implanted over a 4-year period is presented. The results of this study showed 14 of the 21 cases were successful (66.7%), while 7 cases had complications including exposure of the metal frame (5 cases), mobility of the device (1 case) and 1 case failed for reasons unrelated to the device. Four of the 7 cases were successfully salvaged resulting in an overall success rate of 85.7% (18 /21 cases). This study supports the use of fully customized subperiosteal jaw implants as a simple and reliable alternative for dental rehabilitation of atrophic edentulous cases which would otherwise require bone grafts for conventional fixed dental implant solutions. With more research, the clinical potential for this device is significant as it not only avoids the need for complex and lengthy reconstructive jaw surgery but also allows for the placement of immediate prosthetic teeth at the time of implantation.

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References

  1. Spencer KR (2018) Implant based rehabilitation options for the atrophic edentulous jaw. Aust Dent J 63(Suppl 1):S100–S107

    Article  PubMed  Google Scholar 

  2. Cawood JI, Howell RA (1988) A classification of the edentulous jaws. Int J Oral Maxillofac Surg 17:232–236

    Article  CAS  PubMed  Google Scholar 

  3. Esposito M, Grusovin MG, Felice P, Karatzopoulos G, Worthington HV, Coulthard P (2009) The efficacy of horizontal and vertical bone augmentation procedures for dental implants—a Cochrane systematic review. Eur J Oral Implantol 2:167–184

    PubMed  Google Scholar 

  4. Aghaloo TL, Moy PK (2007) Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants 22(Suppl):49–70

    PubMed  Google Scholar 

  5. Chiapasco M, Casentini P, Zaniboni M (2009) Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants 24(Suppl):237–259

    PubMed  Google Scholar 

  6. Schmidt BL (2007) Maxillary reconstruction using zygomaticus implants. Atlas Oral Maxillofac Surg Clin North Am. 15(1):43–9

    Article  PubMed  Google Scholar 

  7. Dawood A, Marti BM, Sauret-Jackson V, Darwood A (2015) 3D printing in dentistry. Br Dent J 219:521–529

    Article  CAS  PubMed  Google Scholar 

  8. Mommaerts MY (2017) Additively manufactured sub-periosteal jaw implants. Int J Oral Maxillofac Surg 46:938–940

    Article  CAS  PubMed  Google Scholar 

  9. Mangano C, Bianchi A, Mangano FG, Dana J, Colombo M, Solop I, Admakin O (2020) Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series. 3D Print Med. 6(1):1. https://doi.org/10.1186/s41205-019-0055-x

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cerea M, Dolcini GA (2018) Custom-made direct metal laser sintering titanium subperiosteal implants: a retrospective clinical study on 70 patients. Biomed Res Int 28(2018):5420391. https://doi.org/10.1155/2018/5420391

    Article  CAS  Google Scholar 

  11. Ângelo DF, Vieira Ferreira JR (2020) The role of custom-made subperiosteal implants for rehabilitation of atrophic jaws - a case report. Ann Maxillofac Surg 10:507–511

    Article  PubMed  PubMed Central  Google Scholar 

  12. Mounir M, Atef M, Abou-Elfetouh A, Hakam MM (2018) Titanium and polyether ether ketone (PEEK) patient-specific sub-periosteal implants: two novel approaches for rehabilitation of the severely atrophic anterior maxillary ridge. Int J Oral Maxillofac Surg 47:658–664

    Article  CAS  PubMed  Google Scholar 

  13. Stefano N, Lorenzo V (2021) The use of digital sub-periosteal implants in severe maxillary atrophies rehabilitation: a case report. J Head Neck Spine Surg 4:555636. https://doi.org/10.19080/JHNSS.2021.04.555636

    Article  Google Scholar 

  14. Gellrich NC, Zimmerer RM, Spalthoff S, Jehn P, Pott PC, Rana M, Rahlf B (2017) A customised digitally engineered solution for fixed dental rehabilitation in severe bone deficiency: a new innovative line extension in implant dentistry. J Craniomaxillofac Surg 45:1632–1638

    Article  PubMed  Google Scholar 

  15. Claffey N, Bashara H, O’Reilly P, Polyzois I (2015) Evaluation of new bone formation and osseointegration around subperiosteal titanium implants with histometry and nanoindentation. Int J Oral Maxillofac Implants 30:1004–1010

    Article  PubMed  Google Scholar 

  16. Beddis H, Lello S, Cunliffe J, Coulthard P (2012) Subperiosteal implants. Br Dent J 13:212–214

    Google Scholar 

  17. Demirdjan E (1998) The complete maxillary subperiosteal implant: an overview of its evolution. J Oral Implantol 24:196–197

    Article  CAS  PubMed  Google Scholar 

  18. Stevenson AR (1993) The subperiosteal implant. Aust Dent J 38:413

    Article  CAS  PubMed  Google Scholar 

  19. Schou S, Pallesen L, Hjørting-Hansen E, Pedersen CS, Fibæk B (2000) A 41-year history of a mandibular subperiosteal implant. Clin Oral Implants Res 11:171–178

    Article  CAS  PubMed  Google Scholar 

  20. Silvestri KD, Carlotti AE (1995) Subperiosteal implant: serving the dental profession for over 50 years. R I Dent J 28(11–3):23

    PubMed  Google Scholar 

  21. Dahl G (1956) Dental implants and superplants. Rass Trimest Odontoiatr 4:25–36

    Google Scholar 

  22. Bodine RL, Yanase RT, Bodine A (1996) Forty years of experience with subperiosteal implant dentures in 41 edentulous patients. J Prosthet Dent 75:33–44

    Article  CAS  PubMed  Google Scholar 

  23. Sconzo J (1998) The complete mandibular subperiosteal implant: an overview of its evolution. J Oral Implantol 24:14–15

    Article  CAS  PubMed  Google Scholar 

  24. Moore DJ, Hansen PA (2004) A descriptive 18-year retrospective review of subperiosteal implants for patients with severely atrophied edentulous mandibles. J Prosthet Dent 92:145–150

    Article  PubMed  Google Scholar 

  25. Van den Borre C, Rinaldi M, De Neef B, Loomans NAJ, Nout E, Van Doorne L, Naert I, Politis C, Schouten H, Klomp G, Beckers L, Freilich MM, Mommaerts MY (2021) Radiographic evaluation of bone remodeling after additively manufactured subperiosteal jaw implantation (AMSJI) in the maxilla: a one-year follow-up study. J Clin Med. 10(16):3542

    Article  PubMed  PubMed Central  Google Scholar 

  26. De Moor E, Huys SEF, van Lenthe GH, Mommaerts MY, Vander Sloten J (2021) Mechanical evaluation of a patient-specific additively manufactured subperiosteal jaw implant (AMSJI) using finite-element analysis. Int J Oral Maxillofac Surg 28:S0901–5027(21)00178–8. https://doi.org/10.1016/j.ijom.2021.05.011

  27. Van den Borre C, Rinaldi M, De Neef B, Loomans NAJ, Nout E, Van Doorne L, Naert I, Politis C, Schouten H, Klomp G, Beckers L, Freilich MM, Mommaerts MY (2021) Patient- and clinician-reported outcomes for the additively manufactured sub-periosteal jaw implant (AMSJI) in the maxilla: a prospective multicentre one-year follow-up study. Int J Oral Maxillofac Surg. 29:S0901–5027(21)00198–3. https://doi.org/10.1016/j.ijom.2021.05.015

  28. Carnicero A, Peláez A, Restoy-Lozano A, Jacquott I, Perera R (2021) Improvement of an additively manufactured subperiosteal implant structure design by finite elements based topological optimization. Sci Rep. 11(1):15390. https://doi.org/10.1038/s41598-021-94980-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Gellrich NC, Rahlf B, Zimmerer R, Pott PC, Rana M (2017) A new concept for implant-borne dental rehabilitation; how to overcome the biological weak-spot of conventional dental implants? Head Face Med 13:17

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The contribution of Biomedical engineers at MAXONIQ (www.maxoniq.com) who helped design, develop, and manufacture this device, commercially known as the OsseoframeTM, is gratefully acknowledged.

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Authors and Affiliations

  1. Head & Neck Clinical Institute, Epworth-Freemasons Hospital, Suite 1, Ground Floor, 124 Grey Street, East Melbourne, Melbourne, VIC, 3002, Australia

    George Dimitroulis

  2. Hunter Oral & Maxillofacial Surgery, Newcastle, NSW, Australia

    Benjamin Gupta & Ian Wilson

  3. Melbourne, Australia

    Christopher Hart

Authors
  1. George Dimitroulis
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  2. Benjamin Gupta
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  3. Ian Wilson
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  4. Christopher Hart
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Correspondence to George Dimitroulis.

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Ethical approval

The clinical use of the subperiosteal device described in this article, otherwise referred to as the Osseoframe, has been reviewed and approved by the Epworth Hospital Ethics Board on Human research (EH2016/07) and has therefore been performed in accordance with the ethical standards laid down in the Declaration of Helsinki (as revised in Brazil 2013). The Osseoframe has been approved for clinical use by the Australian Therapeutic Goods Administration (TGA) as a Class IIb implantable medical device (ARTG listing 286266).

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All the patients have provided their consent to participate in this study.

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All the authors provide their consent to publish.

Competing interests

Author (GD) holds shares in MAXONIQ, the company that manufactures the medical device described in the article. All other authors declare no competing interests.

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Dimitroulis, G., Gupta, B., Wilson, I. et al. The atrophic edentulous alveolus. A preliminary study on a new generation of subperiosteal implants. Oral Maxillofac Surg 27, 69–78 (2023). https://doi.org/10.1007/s10006-022-01044-3

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  • DOI: https://doi.org/10.1007/s10006-022-01044-3

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