DentalSubperiosteal implants
A subperiosteal implant is a custom titanium framework that rests on the jawbone rather than inside it — a niche option for severe bone loss when standard implants, grafting and zygomatic implants are not suitable.
Last reviewed: 20 July 2026
What subperiosteal implants are
Conventional (endosteal) implants are placed inside the bone. A subperiosteal implant instead is a custom-made frame that rests on the surface of the jawbone, beneath the gum, with posts protruding through the gum to hold a bridge or denture. It was one of the earliest implant designs, largely replaced by root-form implants and grafting. It has seen renewed, selective interest in modern form because CBCT scanning and CAD/CAM (and 3D-printed titanium) now allow a precise, custom-milled frame designed digitally to fit an individual jaw.
It is a specialised, relatively uncommon option, generally reserved for people with severe bone loss who are not suitable for grafting, zygomatic implants, or standard implants — not a routine alternative.
Who it suits — and who it may not
Occasionally considered for people who: have severe jawbone atrophy, cannot or do not want extensive grafting, and are not candidates for other advanced options. Not a first-line choice for anyone who can be treated with standard implants, All-on-4, grafting, or zygomatic implants, which have longer track records. Because evidence and long-term data for modern subperiosteal designs are more limited than for endosteal implants, it deserves particularly careful discussion of the trade-offs.
Step by step
- 1. CBCT and digital design A 3D scan is used to design a custom framework that matches the bone surface precisely.
- 2. Manufacture The frame is milled or 3D-printed in titanium.
- 3. Surgery The gum is opened, the frame is seated on the bone, and it is fixed in place; posts pass through the gum.
- 4. Healing The gum heals over the frame; soft tissue health around the posts is important.
- 5. Restoration A bridge or denture is attached to the protruding posts.
Materials and approach
Modern subperiosteal frames are custom titanium, produced with CAD/CAM milling or additive (3D-printing) manufacturing based on the patient's scan. This is a specialised area offered by relatively few clinics and surgeons, and the components are bespoke rather than off-the-shelf system parts.
Risks and honest limitations
The historic version had a reputation for higher rates of infection and framework exposure over time. Modern digitally-designed versions aim to reduce these problems, but long-term evidence is still building compared with the decades of data behind standard implants. Specific risks include soft-tissue infection, exposure or loosening of the framework, and difficulty of removal or revision. For most people with bone loss, grafting, All-on-4 or zygomatic implants remain the better-supported options — subperiosteal implants are a considered fallback, not a shortcut.
How the modern version differs from the old design
The original subperiosteal implants of the mid-20th century were made by taking a physical impression of the exposed bone in one operation, fabricating a cast frame, and fitting it in a second operation. Fit was imperfect, and micro-movement and gaps contributed to the infection and exposure problems that gave the technique its reputation. The modern version removes the guesswork: a CBCT scan captures the bone in three dimensions, the frame is designed on a computer to match that surface, and it is milled or 3D-printed in titanium — usually in a single surgery. Better fit is the whole rationale for revisiting the idea. It is still, however, a low-volume technique with far less long-term published data than root-form implants, and that uncertainty should be part of any honest conversation.
Questions worth asking before agreeing
- How many custom subperiosteal cases has this surgeon actually performed, and over how long?
- Why is this recommended over grafting, All-on-4-style tilted implants, or zygomatic implants for my case?
- What is the plan, and the cost, if the framework becomes exposed, infected or loose later?
- What does the long-term evidence actually show, and what follow-up will I have back home?
Typical approach in Turkey and indicative price
A small number of Turkish clinics offer custom subperiosteal implants for selected severe-atrophy cases. Given the bespoke manufacturing and specialist surgery, and the more limited evidence base, ask specifically about the surgeon's experience with this technique, how many cases they have done, and what the plan is if the framework needs revising.
Indicative only (GBP; rates fluctuate) and very case-specific because the framework is custom-made. Verify with the clinic and discuss the limited long-term evidence. See the implant cost guide.
Frequently asked questions
What is a subperiosteal implant?
It is a custom metal framework that rests on top of the jawbone, under the gum, with posts that come through the gum to hold a bridge or denture — as opposed to standard implants that are screwed into the bone. It is used mainly for severe bone loss.
Are subperiosteal implants still used?
They are uncommon and considered a niche option. Modern digital design and 3D-printed titanium have revived selective use for severe atrophy, but for most people grafting, All-on-4 or zygomatic implants have stronger long-term evidence and are preferred.
Who might need a subperiosteal implant?
Someone with severe jawbone loss who is not suitable for grafting, standard implants or zygomatic implants might be considered. It is a fallback for difficult cases rather than a routine choice, and needs a specialist assessment.
Are subperiosteal implants risky?
The historic design had higher rates of infection and framework exposure over time. Modern custom versions aim to reduce this, but long-term data is more limited than for standard implants, so the risks and uncertainties should be discussed carefully with an experienced surgeon.
How is a subperiosteal implant made?
A CBCT scan is used to design a framework that precisely matches the surface of your jawbone, which is then milled or 3D-printed in titanium. It is bespoke to your anatomy rather than an off-the-shelf implant.
Is a subperiosteal implant cheaper than grafting?
Not necessarily — because it is custom-manufactured and requires specialist surgery, it can be expensive, and pricing varies widely. Cost should not be the deciding factor given the more limited evidence base; suitability and surgeon experience come first.
Request general information
Tell us what you are considering and we can share general guide information. We are an independent guide, not a clinic. With your explicit consent, we can pass your enquiry to verified clinics so they can send you a quote.