Custom subperiosteal implants used to rehabilitate the atrophic edentulous maxilla following multiple failures of both conventional as well as zygomatic implants: a case report

The treatment of cleft lip and cleft palate patients typically involves numerous surgeries, often including the replacement of missing teeth and endosseous dental implants are often utilized in this context. Endosseous dental implants require adequate bone volume for placement, and in this patient cohort this often requires an initial alveolar bone graft. Technological advancements can now harness computer-aided design and computer-aided manufacturing (CAD-CAM) to produce modern custom subperiosteal implants that utilize the available bone surface, thus providing an alternative treatment for patients unable to have conventional dental implants. We report the case of a 72-year-old male cleft palate patient who failed a combination of both regular endosseous and zygomatic implants and was left with both hard and soft tissue defects, such that he was not a candidate for further conventional implant placement. Using CAD-CAM technology, custom subperiosteal implants were created to successfully treat his atrophic and severely deformed edentulous maxilla.