Subperiosteal implants
Also known as: Subperiosteal implant, AMSJI, Additively manufactured subperiosteal implant
A custom framework that rests on the jaw bone beneath the periosteum rather than being inserted into it, carrying posts that emerge through the gum to support a prosthesis.
Key facts
| Classification | Has an implant substructure and a superstructure, with a custom cast frame placed directly beneath the periosteumVerified spec[2] |
|---|---|
| Production process | Contemporary versions are CAD-designed and additively manufactured, which the review contrasts with the traditional two-stage surgical approach and associates with one-stage surgery, immediate loading, better fit and reduced surgical timeVerified spec[1] |
| Clinical evidence | A 2024 systematic review of 13 studies covering 227 implants in 227 patients reported survival of 97.8% at a weighted mean follow-up of 21.4 monthsClinical evidence |
| Limitations | The same review reported partial framework exposure affecting 25.6% of implants and soft tissue or persistent infection in 5.3% of patients; it found no randomised controlled trials, could not perform a meta-analysis because of heterogeneity, and rated the certainty of the evidence as Very Low using GRADEClinical evidence |
| Typical use | Considered where alveolar bone is too resorbed to house implants and the patient is unsuitable for, or unwilling to undergo, extensive grafting. |
Overview
A subperiosteal implant is not placed in the bone at all: it is a custom-made frame that sits on the jaw under the gum lining, with posts protruding to carry a bridge. The design dates from the middle of the twentieth century and largely disappeared once root-form implants proved reliable, but it has returned in a new form — designed on a CT scan and 3D-printed in titanium — for people whose jaws are too resorbed to accept conventional implants. The published results look encouraging at first glance, with survival around 97.8%, and the qualification matters more than the number: mean follow-up is only about 21 months, a quarter of cases showed some exposure of the framework through the gum, there are no randomised trials, and the systematic review that pooled these studies rated the certainty of the evidence as very low. It is best understood as a salvage option under active investigation rather than an established alternative to grafting.
Sources
Numbers match the citations beside each claim above.
Clinical evidence
- [1]Clinical performance of additively manufactured subperiosteal implants: a systematic review — International Journal of Implant Dentistry (PMC), 2024. Accessed 2026-07-21.
Additional references
- [2]Dental Implants (StatPearls) — StatPearls Publishing / NCBI Bookshelf, 2023. Accessed 2026-07-21.