What are Subperiosteal Implants? Everything You Need to Know

If your dentist has brought up subperiosteal implants, it’s normal to feel a bit unsure at first. The name sounds complicated, and you probably have a lot of questions running through your mind. Should you consider it? Is it safe? What does the process involve? Before you decide anything, it’s worth taking a few minutes to understand what this option really means for you. This guide breaks it all down in a simple, no-stress way so you know exactly what to expect.

What Are Subperiosteal Implants?

Subperiosteal implants are a type of dental implant that sits on top of the jawbone, under the gum tissue, and are used for patients with insufficient bone for traditional endosseous implants. Instead of going into the bone, this implant sits on top of the jawbone but under the gum. It’s a custom-made metal framework that fits your jaw and includes small posts that stick out through the gums. These posts hold your dental bridge or denture in place, giving you a stable option when bone loss makes regular implants difficult.

Subperiosteal Implant Procedure

If you're considering subperiosteal implants, it helps to understand each step of the procedure so you know exactly what to expect. Here's how the process usually goes:

1. Initial Assessment and Diagnostic Imaging

Your dentist will start with a thorough examination of your mouth. This includes taking X-rays and, in many cases, a CT scan. These images help assess the condition of your jawbone and decide whether subperiosteal implants are the right option for you. Since this type of implant sits on top of the bone rather than going inside it, the structure and shape of your jaw are very important.

2. Impression Taking

Next, the dentist will take precise impressions of your jaw. These are basically molds that capture the exact contours of your bone. This part is extremely important because the entire implant will be custom-made based on these impressions.

3. Framework Fabrication

After the impressions are ready, they’re sent to a dental lab where skilled technicians create a custom metal framework. This is usually made from titanium because it’s strong, light, and works well with the body. The framework is carefully designed to fit snugly over your jawbone.

4. Surgical Placement

During surgery, your gum is gently opened to expose the jawbone. The custom metal framework is then carefully placed over the bone. Small posts, called abutments, are attached to the framework. These will stick out through the gums and later support your artificial teeth. Once everything is in place, the gum tissue is stitched back over the framework, leaving the posts visible.

5. Limited Osseointegration

Unlike endosteal implants, subperiosteal ones don't rely fully on bone fusion. However, some minor bonding between the bone and the framework might still happen. Most of the support comes from how well the framework fits and how the nearby tissues hold it in place.

6. Prosthetic Placement

After a healing period, which can take a few weeks to a few months depending on your case, your dentist will attach the final prosthetic teeth. These might be in the form of a bridge or a denture. Once attached, they look and function like natural teeth, giving you back your smile and the ability to chew comfortably.

Advantages of Subperiosteal Dental Implants

If you're considering subperiosteal dental implants, it's worth understanding the specific benefits they offer. Unlike traditional implants that go into the jawbone, subperiosteal implants rest on top of the bone but under the gum. This approach comes with several advantages that might make it a better choice for your situation.

1. No Need for Bone Grafting

One of the biggest advantages is that you can often skip bone grafting. If your jawbone isn't strong or thick enough for traditional implants, subperiosteal implants may still work for you. This can save you an extra procedure, along with the healing time and costs that come with it.

2. A Good Option for Those with Bone Loss

If you’ve been told you don’t have enough bone to support regular implants, don’t worry. Subperiosteal implants are specifically designed for people with limited bone height or density. They rest on the bone instead of going into it, making them ideal when bone structure is an issue.

3. Custom-Made to Fit Your Jaw

These implants aren’t pulled off a shelf. A precise scan or impression of your jaw is taken, and then the implant is custom-designed to fit your unique bone structure. This personalised approach means better comfort, more stability, and a natural feel once everything is in place.

4. Can Support Different Types of Restorations

Whether you need a single tooth replaced or a full arch, subperiosteal implants are flexible enough to support various types of dental restorations. This makes them a versatile option no matter what kind of dental work you’re looking to get.

5. May Reduce the Overall Treatment Time

Because there’s usually no bone grafting involved and healing times can be shorter, your total treatment timeline might be quicker. That means you get back to eating, speaking, and smiling with confidence a little sooner.

6. Sometimes Involves Less Invasive Surgery

In certain cases, the procedure to place subperiosteal implants can be less invasive compared to the traditional method. This could mean less discomfort after surgery and a smoother recovery.

7. Strong and Long-Lasting

Despite sitting on the bone rather than inside it, subperiosteal implants are still made from durable materials like titanium. When properly cared for, they offer strong support for your replacement teeth and can last for many years.

Risks and Complications of Subperiosteal Dental Implants

If you’re considering subperiosteal dental implants, it’s important to understand the possible risks that come with them. Here’s what you should know before making a decision.

1. Invasive Procedure

The placement of subperiosteal implants is more invasive compared to other types. Since the implant frame is positioned on top of the jawbone but under the gums, it requires careful surgery. This means there can be more swelling, discomfort, and a slightly longer recovery time after the procedure.

2. Increased Complications

Because the implant rests on the bone rather than being inserted into it, there’s a slightly higher chance of complications. The structure can sometimes become loose or shift if the surrounding tissue doesn’t heal properly.

3. Infection

Like any surgery, there’s a risk of infection if bacteria enter the surgical site. Maintaining proper oral hygiene and following your dentist’s aftercare instructions can help reduce this risk. Sometimes, antibiotics may be prescribed to keep the area clean and infection-free.

4. Gum Irritation

Since the implant frame rests beneath the gums, some people may experience irritation or soreness in that area. The gums might take time to adjust to the implant, especially in the first few weeks after placement. Regular cleaning and gentle care can help the tissue heal comfortably.

5. Bone Loss

One drawback of subperiosteal implants is that they do not fuse directly with the bone like endosteal implants do. Over time, this can lead to gradual bone loss underneath the frame. This makes it important to have routine check-ups so your dentist can monitor bone health and make adjustments if needed.

6. Long-Term Success Rate

While many patients have successful outcomes, subperiosteal implants may not last as long as traditional implants. Their long-term stability depends on how well they’re fitted, your bone quality, and how well you care for them. Consistent dental visits and proper maintenance are essential to extend their lifespan.

7. Higher Cost

Because the procedure involves advanced imaging, customised implant design, and more complex surgery, subperiosteal implants often cost more than standard ones. It’s a good idea to discuss all expenses in advance so you know what to expect before committing.

8. Limited Long-Term Data

Compared to other types of implants, there isn’t as much long-term research on subperiosteal implants. While newer materials and techniques have improved outcomes, there’s still limited evidence about how well they perform over several decades.

9. Difficulty in Cleaning

Cleaning around subperiosteal implants can be tricky since the metal frame sits under the gumline. Plaque buildup can occur if not cleaned properly, increasing the risk of gum disease or infection. Following a proper cleaning routine and using specialised dental tools can make a big difference in keeping your implants healthy.

When Should You Consider Subperiosteal Implants?

Subperiosteal implants aren’t the first option for everyone, but they can be a great choice in certain cases. Let’s look at when they work best.

1. When You Have Low Bone Density or Height

If your jawbone has thinned over time, you might not have enough bone to support a regular implant. This can happen because of gum disease, injury, or missing teeth that were never replaced. In such cases, subperiosteal implants work well since they sit on top of the jawbone rather than being drilled into it. This means you can still get stable, long-lasting support without needing bone grafting.

2. When Bone Grafting Isn’t an Option

Some people can’t go through bone grafting because of age, medical conditions, or simply wanting to avoid extra surgery. If that sounds like you, subperiosteal implants offer a practical alternative. They don’t require bone rebuilding and can still give a strong base for replacement teeth.

3. When You Need Full-Arch Restoration

If you’re missing all your upper or lower teeth and regular implants can’t be placed due to bone loss, subperiosteal implants can help. They’re designed to hold a full set of prosthetic teeth securely in place, improving both comfort and appearance. This approach is especially useful when a complete restoration is needed.

4. When Previous Implants Have Failed

If traditional implants didn’t work for you because of weak bone support or other complications, subperiosteal implants might be the right next step. They provide a different kind of anchoring system that doesn’t rely on bone density, which makes them a good backup solution for complex cases.

Before deciding, it’s essential to consult a qualified dental surgeon. We recommend that you visit your nearest Dezy Dental Clinic. They’ll examine your jaw structure through scans and imaging to see if subperiosteal implants are suitable for you. With the right planning and placement, they can restore your smile comfortably and safely.

Cost of Subperiosteal Implants in India

The cost for a subperiosteal implant in India is typically between ₹60,000 and ₹1,50,000, though it can vary depending on the clinic, the surgeon’s expertise, and how complex your case is. This range generally covers the custom metal framework and the surgical placement, but the total cost may increase once you factor in essentials like CT scans, diagnostic imaging, surgical fees, and the final prosthetic teeth. Because these implants are customised to fit your jawbone, the level of precision required can influence the overall pricing. A detailed consultation with your dentist will give you the most accurate estimate based on your needs.

Subperiosteal Implant Recovery and Aftercare Considerations

Getting a subperiosteal implant is a major step, and how you care for yourself afterward plays a huge role in how well it heals. Let’s walk through what you can expect during recovery and what you need to do to take care of the implant in both the short and long term.

Recovery Timeline

1. First 24–48 hours

This is when your body starts responding to the surgery. Swelling, mild bleeding, and some discomfort are completely normal. Make sure to follow your dentist’s instructions carefully. Use cold compresses if advised, rest as much as you can, and avoid touching or disturbing the implant area.

2. First 1–2 weeks

Most of the initial swelling and soreness starts to settle down during this time. You’ll begin to feel more like yourself, but your mouth is still healing. Stick to soft foods, stay away from anything too hot or spicy, and avoid strenuous activity that might put stress on your jaw. Good oral hygiene without disturbing the implant site is important from the very start.

3. First 3–6 months

This is the deeper healing phase, where the tissues around the implant gradually adjust and stabilise. You may not feel anything major during this time, but regular check-ups are important. Your dentist will monitor how the implant is integrating and may advise you on when to move forward with the next steps, like placing the final restoration.

4. Post-healing

Once your implant has fully settled, it should start feeling like a natural part of your mouth. At this stage, the focus shifts to keeping it clean and strong for the long haul. Daily care and routine check-ups become the priority.

Aftercare Considerations

Immediate Aftercare (First 48–72 hours)

1. Pain Management

Some discomfort is expected, but it should be manageable with the medication your dentist prescribes or recommends. Avoid over-the-counter painkillers unless advised, and stick to your dosing schedule to stay ahead of the pain.

2. Dietary Adjustments

Stick to soft, cool, and non-spicy foods for the first few days. Soups, smoothies, mashed potatoes, and yogurt are all safe choices. Avoid using straws or chewing on the side where the implant is placed.

3. Preventing Complications

Don’t poke or touch the surgical area with your fingers or tongue. Avoid mouthwash with alcohol, and don’t rinse your mouth too vigorously. If you notice excessive bleeding, pus, or severe pain, contact your dentist right away.

4. Rest

Your body needs energy to heal. Get plenty of rest, keep your head slightly elevated when sleeping, and avoid intense physical activity for at least a few days.

Ongoing Healing and Long-Term Care

1. Oral Hygiene

Clean your mouth gently but thoroughly. Use a soft-bristled toothbrush and follow your dentist’s instructions on rinsing. Floss carefully, and don’t skip brushing twice a day. The cleaner you keep the area, the smoother your recovery will be.

2. Tobacco and Alcohol

Avoid smoking and drinking, especially during the healing period. Tobacco can slow down healing and increase the risk of implant failure. Alcohol can irritate the surgical site and interfere with medications.

3. Protect the Implant

Don’t chew on hard items like ice, pens, or hard candy. If you grind your teeth at night, ask your dentist about a night guard. Any extra pressure or force can cause issues with the implant over time.

4. Regular Dental Visits

Keep up with your dental appointments, especially the follow-up visits in the first few months. Even after healing, schedule regular cleanings and check-ups. Your dentist will make sure everything is staying healthy and spot any problems early.

Who Is a Good Candidate for Subperiosteal Implants?

Subperiosteal implants are meant for a very specific group of people. They aren’t the first choice for everyone but can be a great option when traditional implants aren’t suitable. You may be a good candidate if you’ve lost a significant amount of jawbone and can’t support regular implants.

They’re also suitable for people who don’t want to go through multiple bone grafting procedures or those who medically can’t undergo them. If you wear dentures but find them loose or uncomfortable, subperiosteal implants can offer a much more stable and secure fit.

Before making a decision, your dentist will carry out a full clinical and radiographic examination. This helps them check your bone condition, overall health, and determine if this type of implant is the safest and most reliable option for you.

Closing Thoughts

Choosing subperiosteal implants is not a small decision, but it can be a life-changing one if it fits your needs. With the right planning and care, it offers a strong alternative when regular implants aren’t possible. What matters most is that you feel informed, supported, and ready for each step ahead. Take the time to talk things through with your dental specialist, ask all your questions, and trust the process. A more confident, comfortable smile might be closer than you think.

Frequently Asked Questions (FAQs)

1. How are subperiosteal implants different from regular dental implants?

Subperiosteal implants sit on top of the jawbone but under the gum, while traditional implants go directly into the bone.

2. Do I need a bone graft for subperiosteal implants?

No. These implants are made for people who don’t have enough healthy bone, so there’s usually no need for grafting.

3. Are subperiosteal implants a permanent solution?

Yes, they’re built to last a long time. Just like any implant, they need proper care and regular dental check-ups to stay in good shape.

4. How long does recovery take after the procedure?

Most people can get back to normal activities in a few days. However, full healing inside the mouth may take a few weeks.

5. Can subperiosteal implants be used in both the upper and lower jaw?

Yes. They can be customised for either jaw depending on what the patient needs.

6. How do I take care of my subperiosteal implants?

Stick to good oral hygiene. That means brushing, flossing, and visiting your dentist regularly to keep everything clean and healthy.

7. Are subperiosteal implants a new invention?

Not really. They’ve been around for several decades and were quite common before bone grafting became widely available. Thanks to better materials and surgical methods, they’re now making a comeback for certain cases.

8. How long do these implants usually last?

With proper care, they can last anywhere from 10 to 20 years or even longer. Regular dental visits and good hygiene play a big part in how long they stay strong.

9. What do subperiosteal implants cost?

The cost depends on several things like the complexity of your case, how many implants you need, and where you’re getting the treatment. It’s best to talk to a dental specialist for an accurate estimate.

10. Is the procedure painful?

No. The surgery is done under local anaesthesia or sedation, so you won’t feel pain during the procedure. Some swelling or mild discomfort afterwards is normal, but it can be managed with pain medication your dentist prescribes.

11. What are subperiosteal implants made from?

They’re usually made from strong, biocompatible materials like medical-grade titanium or cobalt-chromium alloy. These materials are safe for the body and built to last.

12. Can I get a full set of teeth attached to these implants?

Yes. Subperiosteal implants can support a full arch bridge or implant-retained dentures. They offer a stable, long-lasting solution if you need to replace all your upper or lower teeth.