A descriptive 18-year retrospective review of subperiosteal implants for patients with severely atrophied edentulous mandibles

Abstract

Statement of problem Fabricating dentures for the patient with severe mandibular atrophy can be a challenge for both the dentist and patient. Subperiosteal implants with a mandibular overdenture may be a solution for the atrophic mandible. Purpose The purpose of this retrospective study was to review the survival of mandibular subperiosteal implants placed at the University of Missouri Kansas City (UMKC) School of Dentistry Graduate Prosthodontics program between 1982 and 2000. Material and methods Forty subperiosteal implants were placed in atrophic mandibles of 40 patients (33 women, 7 men) between 1982 and 2000. The age range of the patients was 47 to 80 years of age at time of placement (mean = 62 years). Each patient was reviewed clinically by an author (DJM). Manual depression and lifting of the framework were used to evaluate the stability of the implant. Additionally, the implants were observed for any movement. Each patient was questioned for pain or discomfort. Each patient was examined for observable inflammation and intraoral exposure of the framework and questioned as to whether the implant had satisfied the patient and met the patient's expectations. Results Thirty-nine of the 40 original patients were recalled in 2000. One patient had died. Fourteen patients had implants for over 10 years, 12 patients had implants between 5 and 10 years, and 12 patients had implants for less than 5 years (mean time of implant service = 8 years). Thirty-eight patients had the implant in place with no sign of inflammation or mobility, 1 patient with diabetes had inflammation around one of the struts. All patients were wearing their prostheses, and there was no sign of exposed implant framework for any patient. All patients reported a high level of satisfaction with the implant. Conclusions Within the limitations of this study, the mandibular implants placed at UMKC were still functioning, and all patients denied any discomfort or pain from the prostheses. Patients reported they were comfortable and able to function with the implant-supported prosthesis.