Q: Dr. Eppley, I wanted to ask you some quetsions about my jaw after a sliding genioplasty. There is a significant gapping on the right side, I can feel underneath the chin )at the sliding genioplasty fracture site. There is slight gapping on the left. First, do you have any suggestions. I would like for my jaw to be more substantial for dental reasons. I have a 11 year old dental implant on the right side in the back and there is a tooth in the right canine area that may require extraction. I think part of the reason that the osteotomy sight didn’t heal well on the right is because I grind my teeth. (i.e the right dental implant didn’t absorb that stress very well) I now wear a guard at night.
I am considering getting prolotherapy or similar treatment in hopes of stimulating bone growth to fill in the non union areas. Would bone cement or fat interfere if bone is attempting to fill in. How long do we need to wait to do surgery?
A: If you are more than three to six months after the original surgery, you are not going to stimulate any bone to grow into the sliding genioplasty defect areas. It will not matter what type of therapy you undergo. Real bone is going to require a bone graft, every other implantable material is a filler/contour material. Anything placed into the bone ago that isn’t bone will prohibit any bone growth into it. The sooner you bone graft it, the sooner it will heal with real bone although I don’t think real bone is absolutely necessary in this common sliding genioplasty step off areas.
Dr. Barry Eppley