A systematic review evaluated the clinical performance of additively manufactured subperiosteal implants (SI) compared to traditional ones in patients with bone atrophy. Thirteen studies involving 227 patients and 227 implants were included. After a mean follow-up of 21.4 months, 97.8% of implants were functional, with 5 failures. 25.6% of implants showed partial exposure, and 5.3% of patients experienced soft tissue or persistent infections. Fractures of interim prostheses occurred in 5.2% of cases. Despite the high survival rate, a notable number of soft-tissue complications were reported. The studies showed significant heterogeneity in design and methodology, preventing a quantitative analysis or meta-analysis. Modern SI demonstrated good short-term survival but required further research to assess medium- and long-term outcomes. The review highlights the potential benefits of additively manufactured SI, including improved fitting, reduced surgery time, and better patient outcomes. However, challenges remain in managing soft-tissue complications and ensuring long-term success. The study emphasizes the need for more research to fully understand the clinical behavior of these implants.A systematic review evaluated the clinical performance of additively manufactured subperiosteal implants (SI) compared to traditional ones in patients with bone atrophy. Thirteen studies involving 227 patients and 227 implants were included. After a mean follow-up of 21.4 months, 97.8% of implants were functional, with 5 failures. 25.6% of implants showed partial exposure, and 5.3% of patients experienced soft tissue or persistent infections. Fractures of interim prostheses occurred in 5.2% of cases. Despite the high survival rate, a notable number of soft-tissue complications were reported. The studies showed significant heterogeneity in design and methodology, preventing a quantitative analysis or meta-analysis. Modern SI demonstrated good short-term survival but required further research to assess medium- and long-term outcomes. The review highlights the potential benefits of additively manufactured SI, including improved fitting, reduced surgery time, and better patient outcomes. However, challenges remain in managing soft-tissue complications and ensuring long-term success. The study emphasizes the need for more research to fully understand the clinical behavior of these implants.