CAD-CAM subperiosteal implants (SPIs) designed to support fixed partial restorations (FPRs) may improve implant survival in patients with significant jawbone loss. The study was published earlier this month in the British Journal of Oral & Maxillofacial Surgery.
Additionally, this treatment may result in fewer complications compared to more time-intensive bone augmentation procedures, the authors wrote.
“SPIs supporting FPRs may offer a reliable alternative for restoring severe bone atrophies, achieving a high survival rate,” wrote the authors, led by Miguel Ruiz-Rincón of the Complutense University of Madrid in Spain (Br J Oral Maxillofac Surg, December 10, 2025).
The study aimed to review current research on CAD-CAM SPIs, with a focus on clinical performance, implant survival, and related complications. It evaluated studies involving CAD-CAM SPI placement in partially edentulous patients, including randomized controlled trials, observational studies, and case series with at least three patients and a minimum follow-up of one year, they wrote.
Articles published through March 31 were included. The primary outcome was implant survival, defined as any SPI remaining in functional occlusion during follow-up while secondary outcomes included biological complications and mechanical or technical issues. The final analysis included seven studies, representing 96 patients and 121 CAD-CAM SPIs.
Across the reviewed studies, the mean follow-up periods ranged from one to four years. The weighted mean survival rate of subperiosteal implants was 99.17%, with only one failure among 121 implants. The failed case involved an anterior maxillary implant in a heavy smoker, resulting in survival rates of 98.77% for maxillary implants and 100% for mandibular implants, they wrote.
Among 108 implants followed for three or more years, one failure occurred, while no failures were reported in the 16 implants with follow-up periods longer than three years. Furthermore, biological complications occurred in 4.13% of implants, and mechanical complications were reported in 7.44%, including implant instability, restoration fractures, and crown recementation.
However, the study was limited by a small sample size. Additional studies involving bone augmentation and other implant techniques are needed to better assess the effectiveness of this approach, the authors added.
“Despite this scoping review’s limitations, CAD-CAM SPIs supporting FPRs may offer a reliable alternative to other more time-consuming bone augmentation techniques,” they concluded.
