Does Metal Hardware from Prior Orthognathic Surgery Need To Be Removed for Custom Jaw Angle Implant Designing?

Q: Dr. Eppley, I have recently undergone orthognathic surgery and see the need to progress with jaw implants to address bony irregularities which have occurred from the operation.

Would the titanium plates in place after orthognathic surgery need to be removed to obtain a CT scan for planning and design of the implants?

If so, should the plates in the upper jaw region be removed as well?

I have heard that any metal in the head would distort the CT scan. Therefore, the plates need to be removed beforehand .

Thank you for your time.

A: There is no need to remove any hardware before getting a 3D CT scan and designing implants off of that scan. Such titanium hardware does not interfere or distort the 3D CT scan. So what you have heard is not accurate. That may have been true twenty years ago but not today. It is very common to design implants after orthognathic surgery of which there is hardware over the chin, jaw angles and maxilla. Should there be metal plates and screws which will lie underneath the implant, the design incorporates their negative image on its undersurface.

Dr. Barry Eppley

Indianapolis, Indiana