The Subperiosteal Implant was originally described in the 1940s. It has since then been utilized with various success rates. In the late 1960s to early 1970s, more and more research has pointed to the fact that:
- Maxillary subperiosteal implants had poor success rates
- Mandibular subperiosteal implants had better success rates
- The success rates depended dramatically on proper implant design
In 1976 Dr. Robert James from Loma Linda University examined this phenomenon in more detail and published a landmark study on the ultrastructural make up of the deep tissues found at the interface with subperiosteal oral implants. This led him eventually to come up with some important theories of how mandibular subperiosteal implants needed to be designed, in order to maximize long-term success rates. Eventually, Dr. James summarized his findings in another landmark publication titled: "Subperiosteal implant design based on peri-implant tissue behavior".
Subperiosteal implants were designed to be used in patients with moderate to severe jaw resorption, where conventional implants were not an option anymore. These implants do not get inserted into the bone, but rather are placed on top of the jaw bone, right underneath the gum tissue. This of course means that each subperiosteal implant must be custom made to the patient's individual three-dimensional jaw morphology. The original protocol called for a two-stage surgery. During the first stage the entire lower jaw was exposed and an impression was taken of the bony jaw. This impression was then poured into a special stone and this stone cast was then used to design and make the implant against.
In 1985 Dr. James came to the rescue again and published a paper on utilizing CT scan data to re-create a stereo lithographic model of the lower jaw bone and use this as a design template for the subperiosteal implant. This became eventually the standard protocol and the surgery could be done in one stage from that point on.
