Can A Chin Reduction Be Used For Bone Grafts For Dental Implants?

Q: Dr. Eppley, I have bilateral implants for my top lateral teeth. I was born without my permanent ones. I had this surgery and the oral surgeon told me my bone was not thick enough for the implants. They did the implant surgery and then did graft work. I had a total of 3 den grafts which my body rejected all three. They said the next step was to use my own bone, by removing it from somewhere or growing new bone from my DNA in a lab and then grafting it. Also, my implants are slightly exposed when I smile big and I am very self conscious about this. I would like this fixed. I am also wondering if I can have this grafting  done with bone from my protruding chin. Is there a way they can reduce and graft in one surgery.

A: Your prior maxillary bone graft failures sound like it was allogeneic or cadaveric bone, which is commonly used and can be successful, is never as good as your own bone. Forget about growing your bone cells in the laboratory, use good stock bone grafts harvested from the nest donor source available…you!!

Small bone grafts can be harvested from numerous face and skull areas. Each graft probably needs to be less than 1 x 1 cm so using your chin is a real likely possibility for  for a donor source. Depending upon how your protruding chin is reduced would determine how the grafts would be harvested and shaped. Chin reductions (bone graft harvests) can be done from an interpositional intraoral osteotomy or from a submental vertical chin reduction approach. When you are using your own bone, it is imperative that it is harvested and placed during the same procedure.

The more practical limitation of using your chin as the donor source for maxillary grafting is whether your surgeon feels comfortable harvesting and reshaping the chin at the same time.

Dr. Barry Eppley

Indianapolis, Indiana