If you need a dental implant but are suffering from bone loss in your jaw, you may be a candidate for a subperiosteal implant. Unlike most implants that are inserted into the bone, this type of implant lies on top of the jawbone under the thin layer of tissue between the bone and the gum (the periosteum).
Implants and Bone Loss
With modern improvements in imaging, bone grafting and implant design, subperiosteal implants are rarely used. Additionally, the Journal of Otolaryngology and Rhinology reports that the failure rates are around 30 to 50 percent, which may also account for their unpopularity. However, in cases where the bone of the maxilla and mandible (upper and lower jaws) is limited, they may be a viable option. Bone loss can happen for many reasons, according to the Mayo Clinic, including advanced age, thyroid problems and calcium deficiencies.
Because the subperiosteal implant sits on top of the bone, it is not limited by the shape or amount of bone present. This method allows a patient to avoid bone grafting and have a faster turnaround to a working set of implanted teeth. Additionally, implants that sit on top of the bone allow for a faster healing process. Ordinary implants require a healing period of several months to allow a union to form between the bone and the implant, or osseointegration.
The Procedures of Subperiosteal Implant
Two surgical procedures are required to make and insert a subperiosteal implant. Unlike standard implants, a subperiosteal must be custom-made to fit the contours of a particular person's bone.
In the first stage, your dentist or oral surgeon will open the gum tissue with a scalpel, exposing the underlying bone. An impression is taken of the bone, capturing the extent and contours of where the framework will sit and the position of the struts that will hold the bridges. After taking the impression, they will close the gums with sutures until the next surgery can be performed. The whole procedure is done under local anesthesia.
For the second step, the gum tissue is reopened with a scalpel and the implant placed onto the bone. Sometimes small screws are used to hold it in place. The tissues are sutured back over the implant frame, leaving anchor pieces called the permucosal extensions protruding from the gum. Finally, the surgeon will place a temporary bridge over the extension and allow the oral tissue to heal over it. A bridge that matches the natural teeth can be cemented onto the extensions after the gums have healed.
Subperiosteal Implant: Recovery and Care
The failure or complication rate of a subperiosteal implant can be high. The best way to prevent problems is to maintain good oral hygiene and follow the post-operative instructions from your dentist or surgeon. Some patients may experience swelling and mild pain in the implant site for a few days, and your dentist may instruct you to eat only soft foods for a week or so, says the Consumer Guide to Dentistry. Smoking can also increase your risk of implant failure and should be avoided. Your dental professional can check for infection and proper gum growth at your follow-up appointments and remove any stitches if necessary.
If you need a tooth replaced, your dentist can help you explore all your options. Getting a proper diagnosis and treatment plan is always the first step to a new smile.