This systematic review evaluates the clinical performance of modern additively manufactured subperiosteal implants (CAD designed and additively manufactured) compared to traditional subperiosteal implants in patients with bone atrophy. The study was conducted using three electronic databases (Medline, Cochrane Library, and SCOPUS) following PRISMA guidelines. Thirteen articles, including 5 cohort studies and 8 case series, involving 227 patients and 227 implants, were selected. After a weighted mean follow-up of 21.4 months, 97.8% of implants were functional, with 58 implants (25.6%) presenting partial exposure, 12 patients (5.3%) suffering soft tissue or persistent infection, and 8 patients (5.2%) experiencing fracture of the interim prosthesis. The review found significant heterogeneity in study design and methodology, precluding a quantitative analysis. Despite good short-term survival rates, modern additively manufactured subperiosteal implants showed a notable number of soft tissue complications. Further studies are needed to assess their medium- and long-term clinical behavior.This systematic review evaluates the clinical performance of modern additively manufactured subperiosteal implants (CAD designed and additively manufactured) compared to traditional subperiosteal implants in patients with bone atrophy. The study was conducted using three electronic databases (Medline, Cochrane Library, and SCOPUS) following PRISMA guidelines. Thirteen articles, including 5 cohort studies and 8 case series, involving 227 patients and 227 implants, were selected. After a weighted mean follow-up of 21.4 months, 97.8% of implants were functional, with 58 implants (25.6%) presenting partial exposure, 12 patients (5.3%) suffering soft tissue or persistent infection, and 8 patients (5.2%) experiencing fracture of the interim prosthesis. The review found significant heterogeneity in study design and methodology, precluding a quantitative analysis. Despite good short-term survival rates, modern additively manufactured subperiosteal implants showed a notable number of soft tissue complications. Further studies are needed to assess their medium- and long-term clinical behavior.