Chin Implant Erosion

Q: Dr. Eppley, I have a question about possible chin implant erosion. I’m a female patient in my thirties. A few years ago I had a medpor chin implant inserted. I was wondering whether I could ask for your input since I understand you are one of the most prominent surgeons when it comes to both craniofacial as well as plastic surgery.

I had a cone beam scan performed a while ago because of some concerns about my teeth. There appears to be (what looks like) a ‘step off’ in the bone at the lower frontal teeth roots, but I’m not sure if I’m seeing this/interpreting this well – I might misinterpret the scan. Could this step off be caused by the chin implant? (It concerns a medpor chin implant). I drew a red arrow in the scan where I appear to see some kind of step off/change in the bone level. I appreciate your opinion. Thank you very much.

A: That stepoff you see is a classic example of chin implant settling (many refer to it as chin implant erosion which is an inaccurate term) This illustrates that despite the biologic nature of an integrated implant material like Medpor, implant settling can and does occur just like occurs in silicone.

By bone resorption I assume you mean periodontal (gum recession) and radiographic evidence of lower alveolar bone levels.  Whether that is a function of the implant I would initially doubt it as the implant sits much lower than the root level. The usual symptoms would be more pain and tooth sensitivity not alveolar bone resorption. But to qualify that answer I would need to see a front view picture of the cone beam to assess the implant’s location under/over the tooth root levels.

Dr. Barry Eppley

Indianapolis, Indiana