CATEGORY AUSTRALASIAN DENTIST 95 CLINICAL fixation screws. Although some cases had a follow-up of 4 years, this is still not sufficient to draw definitive conclusions on the long-term results of rehabilitations with subperiosteal implants. It will be essential to monitor the health of the soft tissues over time, as they are crucial for maintaining an adequate seal around the abutments, preventing implant exposure, and avoiding bone resorption. With the firstgeneration subperiosteal implants, this process typically occurred at ≥5 years from placement. A benefit of the new generation of subperiosteal implants is the housing of the abutments directly at the level of the basal bone, which tends to resorb less over time. Therefore, the implant should be less affected by possible resorption of the bone surrounding the abutments. In this study, splitting of the residual keratinized mucosa and careful conditioning of the soft tissues were sufficient to obtain an adequate amount of keratinized gingiva, preventing exposures and inflammation of the gingiva around the abutment. Future studies should evaluate the feasibility of using connective or gingival grafts. Moreover, the sample size was too small, and the results not supported by finite element analysis, to draw definitive clinical conclusions about the shape of the implants and the site of fixation. Large-scale prospective studies will be necessary to obtain meaningful clinical data. Based on the results of this study, additively manufactured subperiosteal implants could represent a safe and reliable technique for the rehabilitation of severe atrophy of the posterior sectors of the mandible. Pending the results of prospective studies on larger patient series, the choice of implant design should be guided with respect to the principles of osteosynthesis and the biology of the mandibular bone. Studies with longer follow-up will be needed to establish the long-term results of this type of implant- prosthetic rehabilitation. u Ethical approval Ethics Committee of the University of Sassari (PG/2023/6411). Patient consent Obtained. Funding This research was funded by Fondo di Ateneo per la Ricerca 2019-2020 (University of Sassari). Competing interests None. Acknowledgements. We would like to thank Claudio Banzi and Alan Betti for their technical support and for reviewing the section on digital planning. Appendix A. Supporting information Supplementary data associated with this article can be found in the online version at doi:10.1016/j.ijom.2024.01.003. For a complete list of references email gapmagazines@gmail.com Fully Digitalised Subperiosteal Implant Support B&B Dental Implants 08 8331 2257 admin@bnbdental.com.au www.bnbdental.com.au Available from leading dental wholesalers, over 2000 Pharmacies and major online retailers Online Online Now easier to find for your clinic and your patients
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