Do I hae A Jaw Implant Rejection or Infection?

Q: Dr. Eppley, Last year I underwent surgery to improve the mandibular contour through personalized PEEK implants in the chin and jaw. About 3 months after the operation, I had an infection plus a posterior lump on my left side. The doctor drained it, but soon after the abscess turned into a fistula that oozes pus continuously, and it’s been like that for several months. As a consequence of this, the maxillofacial surgeon now proposes to remove the implants as the infection plus abscess and fistula came out as a result of, according to his criteria, a body rejection of the PEEK implants. 

My questions are: 

What has happened to me is due to a rejection (as the doctor assures) or to a potential contamination of the implants before the intervention? 

Can you provide me with some hypotheses about why the infection plus posterior abscess and fistula have appeared? 

Can I go through the same surgery after the current implants have been removed and mouth healed, or there’s any reason/something preventing me to do it? 

Can this happen to me again or is it unlikely? 

Thanks in advance for your help.

A: Throw out the concept of ‘rejection’ of the implant as that is not a biologically accurate explanation…this is an infection….a known risk of any implant surgery and the risks are higher when the implant is introduced through the mouth which is not sterile and can not really be made to be so at the time of surgery.

Implant Infections fool patients because they occur much later than patients are aware…anywhere from 3 weeks to 3 months after the surgery. (most do occur by 6 weeks) When they occur the implant fate is largely sealed due to the development of biofilm on the implant which can not be eradicated by antibiotics alone. Antiubiotics may suppress it for a period of time but can not usually cure it. Removal of the implant is the definitive cure. Implant replacement can be done 6 to 12 weeks later. The risk of implant infection is the same each time the surgery is done. The key question is always what is going to be done differently the next time to try and prevent it from occurring again.

Dr. Barry Eppley

World-Renowned Plastic Surgeon