No More Natural Teeth: Deciding Between Implants and Dentures

Subperiosteal Dental Implants: An Alternative To Bone Grafting?

by Jeremiah Barnett

Dental implants are becoming increasingly popular and for good reason. Compared to bridges, dentures, and other methods used to replace missing teeth, implants are more durable, easier to care for, and a lot more convincing. However, the most common type of dental implants, endosteal implants, may not be suitable for your needs.

The Problem With Endosteal Implants

When a dental implant is installed, the oral surgeon or periodontist anchors the implant in place by drilling a titanium 'post' directly into your jawbone. This arrangement provides the implant with strength and stability, preventing it from shifting and damaging your gum tissue.

However, this post can only be installed if there is enough jawbone material to securely fix it in place. The jawbone beneath a lost tooth frequently starts to atrophy after the tooth falls out or is extracted. This bone loss sometimes occurs within weeks of the loss of the original tooth.

Your jawbone may also have lost strength and density if you suffered from a serious infection in your gums or tooth. Periodontitis, a severe form of gum disease, is a common cause of tooth loss, and the bacteria that cause it can spread their infection into the jawbone, causing significant bone loss.

How Can Bone Grafting Solve This Problem?

In cases where the jawbone has atrophied too much to accommodate endosteal implants, extra bone can be grafted to the weakened jawbone to provide the necessary support. 

If the atrophy in your jawbone is relatively minor, a small bone graft can be performed immediately before your endosteal implants are installed. If bone loss is more severe, a larger graft will need to be placed. These large grafts are more invasive, and most dental implant specialists will wait for at least six months before installing the implant(s) to give the bone graft enough time to take.

This procedure may sound a little gruesome, but many experienced implant specialists have performed thousands of bone grafts, so there is very little risk of complications. There is, however, an alternative to bone grafting and endosteal implants - subperiosteal implants.

What Are Subperiosteal Implants?

Subperiosteal implants are attached to metal posts in the same way as endosteal implants, but these posts are not drilled into the jawbone. Instead, they are attached to a synthetic frame, which is inserted into your gum tissue and rests on top of the jawbone.

This arrangement does not provide as much strength and stability as endosteal implants, and subperiosteal implants generally require more maintenance and aftercare. However, they offer a much shorter recovery period than endosteal implants with bone grafts and can be installed more quickly. They are also just as visually convincing as endosteal implants.

Which Should You Choose?

If you have suffered from jawbone loss that requires grafting before endosteal implants can be installed, subperiosteal implants may be right for you. They are especially useful for people who have lost several adjacent teeth or have suffered from severe infections that have caused pronounced bone loss. In these cases, grafting enough bone to fit endosteal implants may be prohibitively expensive or time-consuming.

However, the long-term benefits of endosteal implants with bone grafts are more pronounced. You won't have to worry about stability issues in the future, and the added durability of endosteal implants makes accidental damage less likely.

Ultimately, only you can decide which option is best for you, but you should consult closely with a reputable dental implant clinic before making your decision. Dental specialists will use a variety of imaging techniques, such as X-rays and ultrasound scanning, to map the contours of your jawbone. This allows them to accurately ascertain the extent of bone loss in your jawbone, and recommend the right type of implant for your needs.