Does PMMA Custom Jaw Angle Implants Have A High Infectivity Rate?

Q: Dr. Eppley, Perusing through your website I realized that there is a section where people ask you questions and your answer them back,since I could find where I could submit you questions I would like to ask you here if you don’t mind!

I would love an advice from a world leading expert like yourself in jaw angle implants,i live in Brazil and here the only material used in this procedure is the off the shelf medpor implant but I found an oral and maxillofacial professional who does custom PMMA jaw angle implants,since information about this procedure done with PMMA implants is very scarce and almost non existent I would like to make you some questions before proceeding with said professional:

A – From what I gathered,PMMA has a higher chance of infection than silicone,but how much higher is this risk exactly?I read that silicone jaw angle implants have a 4% to 6% chance of infection,how much it is for PMMA?

B – MEDPOR is more difficult to remove due to tissue in growth,does PMMA has the same issue?

C – Is PMMA implants visible on CT scan for future removal or replacement?

D – Does PMMA offer any advantage at all compared to other materials available on the market?As I said,I live in Brazil and,unfortunately,due to geographical and financial reasons I could only afford to do this procedure here with the off the shelf MEDPOR or with customized PMMA implants

Sorry if this seems too lenghty,I just think it is vital to ask all of this to the most experienced professional out there in this procedure,I would be kindly thankful to you if you could help me navigate through this all!

A:In answer to your questions:

1) PMMA has a higher infectivity rate than silicone in the face but how much higher is not precisely known.

2) PMMA is non-porous, unlike Medpor, thus its tissue attachments are less. But it is still not an easy material to remove because it is so hard.

3) PMMA implants would not be visible on a 3D CT scan.

4) I see no advantages to PMMA material over Medpor other then the ‘customizable’ part but I really don’t know what that means. The term custom can have various interpretations.

Dr. Barry Eppley

World-Renowned Plastic Surgeon