As far as dental implant procedures go, there are two main forms of attaching implants to a patients jawbone so that permanent dental crowns, bridges or dentures can be attached to them. Below we describe each method in detail, explaining when each one would be used.
Endosteal Dental Implants
Endosteal dental implants are the most effective way to replace missing teeth. The procedure is simpler than a subperiosteal procedure and the end result is much more stable. These types of implants are surgically inserted directly into the jawbone, most often through the form of a standard size or miniature titanium post.
This titanium post will then osseointegrate with the surrounding jawbone over a period of several months before it is strong enough to support a prosthetic tooth. By the time the procedure is complete, the patient will have a fully functioning tooth replacement that is almost identical to the natural tooth.
The main requirement to receive an endosteal dental implant is that the patients jawbone must have the appropriate width, height and density to be able to support an implant, or they must be able to undergo a bone grafting procedure that can repair the jawbone to acceptable levels. Without adequate bone strength, the dental implants will not be strong enough to support prosthetic teeth that will be subject to occlusal forces common in the mouth.
Subperiosteal Dental Implants
When a patient has lost a significant amount of their jawbone height, which can not be restored through bone grafting, subperiosteal implants can be used to support a prosthetic denture. This is a less common scenario and usually occurs in patients who have had an entire arch of missing teeth for a long enough time that the height of the jawbone has deteriorated beyond repair.
Subperiosteal dental implants, as opposed to endosteal, requires attaching a custom made metal frame onto the deteriorated jawbone. The patients gum tissue is first cut open, giving the dental surgeon access to the jawbone. The metal frame is then securely attached to the jawbone with several posts attached to the frame. Once attached, the gum tissue is stitched up to cover most of the metal frame, leaving the posts accessible so that a denture can be permanently fixed to the implants.
These types of implants are much less effective than endosteal implants because they do not have the same strength as a root form implant that has fused with the surrounding bone structure. They also do not prevent the jawbone from deteriorating further, potentially causing them to eventually become loose.
To add to the downside of subperiosteal implants being less effective than endosteal, they are also more costly due to the complexity of the procedure, typically costing over $20,000 depending on various factors.