The Digital Renaissance of Customized Subperiosteal Implants-Clinical Outcomes, Surgical Workflow, and Current Evidence for the Rehabilitation of Severely Atrophic Jaws: A Narrative Review

Background/Objectives: Rehabilitation of the severely atrophic edentulous jaw remains one of the most demanding challenges in oral and maxillofacial reconstruction, particularly when extensive bone augmentation is contraindicated, has previously failed, or is refused by the patient. Subperiosteal implants, first introduced in the 1940s and largely abandoned due to poor long-term performance, have re-emerged over the past decade as a viable alternative through the integration of cone-beam computed tomography (CBCT)-based virtual planning, computer-aided design/computer-aided manufacturing (CAD/CAM), and additive manufacturing. This review summarizes current evidence on the clinical outcomes, surgical workflow, and indications of customized, digitally designed subperiosteal implants. Materials and Methods: A structured literature search was performed in PubMed and Scopus, supplemented by manual searching, to identify publications relevant to the predefined clinical and conceptual scope of this narrative review. Search terms addressed subperiosteal implants, digital/CAD-CAM workflows, additive manufacturing, severe jaw atrophy, and clinical outcomes. Predefined selection criteria were applied to maintain consistency with the scope of the review, and the literature-selection process was documented using a descriptive flow diagram.