What Is a Sub-Periosteal Implant?
An Elegant Solution for a Complex Problem
A sub-periosteal implant is a type of dental implant that rests on top of the jawbone, beneath the gum tissue, rather than being inserted into the bone the way conventional endosseous implants are. It is custom-fabricated — using precise 3D imaging of the patient's bone anatomy — to sit flush against the surface of the ridge and provide stable support for a prosthetic tooth or set of teeth.
Sub-periosteal implants were actually one of the earliest forms of dental implantology, introduced decades before the modern titanium screw implant became the standard of care. While they fell out of widespread use as bone grafting techniques improved, they have experienced a significant resurgence in recent years — driven by advances in 3D imaging and computer-aided design that allow for unprecedented precision in fabrication. Today, the sub-periosteal implant is recognized as a sophisticated and highly effective solution for a select group of patients — earning it the title of "the hidden gem of implantology."
See It in Action
Sub-Periosteal Implants — Clinical Examples
The images below show real sub-periosteal implant frameworks and restorations, illustrating how the custom-fabricated structure conforms to the bone and supports a full set of fixed teeth.
Who Is a Candidate?
When Sub-Periosteal Implants Are the Right Choice
Sub-periosteal implants are indicated for patients who have experienced severe jawbone resorption — typically long-term denture wearers, patients who have lost teeth due to advanced periodontal disease, or individuals who are not candidates for bone grafting due to medical conditions, prior radiation, or personal preference. The key criterion is insufficient bone height or width to accommodate a conventional implant, even after grafting.
These patients are often told by other providers that implants are simply not possible. The sub-periosteal implant offers a compelling alternative — avoiding the need for extensive bone grafting, significantly reducing treatment time, and delivering a fixed, stable restoration on a bone structure that conventional approaches cannot utilize.
The Process
What to Expect
Treatment begins with a high-resolution cone beam CT scan that captures a precise 3D model of the patient's jawbone. Using this data, the sub-periosteal implant framework is digitally designed and custom-fabricated in a dental laboratory to match the exact contours of the bone surface. The result is a framework that fits with remarkable precision — distributing load evenly across the ridge and providing a stable platform for the prosthesis.
Surgical placement involves a single procedure in which the gum tissue is gently reflected, the custom framework is seated directly onto the bone, and the tissue is closed around the implant's abutment posts. Healing typically takes several weeks, after which the final prosthesis is attached. The procedure is performed under local anesthesia with sedation available, and most patients are pleasantly surprised by the straightforward nature of the recovery.
Outcomes
Results & Long-Term Expectations
When properly planned and placed, sub-periosteal implants provide excellent stability, function, and patient satisfaction. They are particularly valued for restoring chewing function and eliminating the instability and discomfort of conventional dentures — outcomes that can dramatically improve quality of life. As with all implant solutions, long-term success depends on maintaining excellent oral hygiene around the framework and prosthesis, and attending regular professional maintenance appointments.
Interested in Learning More?
Schedule a Consultation
If you have been told that implants are not an option for you due to bone loss, the sub-periosteal implant may be the solution that changes everything. Dr. Kampf at NorthStar Implant Dentistry has the specialized knowledge and experience to evaluate whether this approach is appropriate for your anatomy and goals. Contact us today to schedule a comprehensive consultation and find out whether the hidden gem of implantology is right for you.