Improvement of an additively manufactured subperiosteal implant structure design by finite elements based topological optimization

To design a new subperiosteal implant structure for patients suffering from severe Maxillary Atrophy that lowers manufacturing cost, shortens surgical time and reduces patient trauma with regard to current implant structures. A 2-phase finite-element-based topology optimization process was employed with implants made from biocompatible materials via additive manufacturing. Five bite loading cases related to standard chewing, critical chewing force, and worst conditions of fastening were considered along with each specific result to establish the areas that needed to be subjected to fatigue strength optimization. The 2-phase topological optimization tested in this study performed better than the reference implant geometry in terms of both the structural integrity of the implant under tensile-compressive and fatigue strength conditions and the material constraints related to implant manufacturing conditions. It returns a nearly 28% lower volumetric geometry and avoids the need to use two upper fastening screws that are required with complex surgical procedures. The combination of topological optimization methods with the flexibility afforded by additively manufactured biocompatible materials, provides promising results in terms of cost reduction, minimizing the surgical trauma and implant installation impact on edentulous patients.

Severe Mandibular Atrophy Treated With a Subperiosteal Implant and Simultaneous Graft With rhBMP-2 and Mineralized Allograft: A Case Report

A 71-year-old patient was successfully rehabilitated by means of a 3D model-derived, hydroxyapatite-coated titanium subperiosteal mandibular implant. The implant was specifically designed to allow bone augmentation. The deficient bone was simultaneously grafted with mineralized bone allograft and recombinant bone morphogenetic protein −2 (rhBMP–2). The 32-month postoperative cone beam computerized tomography follow-up showed vertical bone augmentation beneath the implant frame.

The Use of Root Form Implants in Overdenture Treatment for the Atrophic Mandible: A Clinical Report

Four short root form implants were inserted in an atrophic mandible and the case restored with a lower connecting bar and an overdenture, opposing a complete maxillary denture. Root form implants were selected, as opposed to a subperiosteal implant in this case. The patient had a favorable medical history, appeared healthy, did not smoke, drink, or do illicit drugs, and had good bone quality.

The Use of Laser Technology (Er;Cr:YSGG) and Stereolithography to Aid in the Placement of a Subperiosteal Implant: Case Study

The use of laser technology has helped this clinician to provide treatment with less postoperative pain and increased healing. The subperiosteal implant is a modality that has been used for several decades, although its popularity has declined in favor of endosseous dental implants. In some instances, however, it remains the treatment of choice, specifically in the atrophic mandible (where placement of endosseous implants is not possible) or when placement would increase the chances of jaw fracture. This article reports the case of a patient rehabilitated using a simplified surgical protocol involving laser surgery and stereolithography.