Introduction
Subperiosteal implants, more recently called AMSJI (Additively Manufactured Subperiosteal Jaw Implants) by some authors are an innovative concept in custom CAD/CAM implants. They perfectly match the ridge anatomy of patients with insufficient bone volume to receive endosteal implants traditionally used in axial implantology. Dr. Gustave Dahl first described the concept of subperiosteal implants in 1940. However, the first implants, made of cobalt-chromium and using a direct bone impression from wide-flap surgery, were not very successful. Their poor fit, lack of stability, and inability to osseointegrate resulted in an excessively high failure and complication rate.
With the advent of digital tools, it is now possible to perfect implant design using materials such as titanium. This advancement considerably improves fitting accuracy. As a result, subperiosteal implants have increased success rates and are becoming a relevant treatment option that deserves our attention.
Complexity of the posterior mandibular region
Treatment of atrophic posterior mandibular regions has long been a challenge in our rehabilitation procedures. The various treatment solutions depend on a number of parameters:
• Removable solutions are rarely accepted due to their
initial bulkiness. Moreover, their instability leads to functional and esthetic limitations. In the most severe cases, they can even cause pain when chewing due to the compression of the inferior alveolar nerve.
• Implant solutions face several anatomical limitations. On one hand, there is a concomitant lack of height and width of the alveolar ridge, making vertical augmentation particularly difficult to achieve. On the other hand, the superficialization of the inferior alveolar nerve considerably increases the risk of postoperative nerve disorders.
Finally, resorption of the bone surface leads to a reduction in the surrounding soft tissue, thus limiting the survival rate of the joint prosthesis.
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