Jaw Angle Implants
Q: Dr. Eppley, I had bone grafts done for my jaw angles about twenty years ago and they have really disappeared. I should have done jaw angle implants as they are permanent. Can you still do jaw angle implants if I had bone grafts placed there previously?
A: Having had prior bone grafts to the jaw angles does not preclude having jaw angle implants later. Onlay bone grafts always undergo irregular but near complete resorption. This has been a lesson learned in craniofacial surgery decades ago. Because the bone graft pushes out the biologic boundary of the bone and is not functionally loaded, it has no reason to persist so it largely resorbs over time.
But the prior placement of bone grafts and any asymmetry that they now cause to the jaw angle bone may indicate the need for custom made jaw angle implants to fit the irregular shape and surface of the bony angles. A 3D CT scan would be good idea to determine the shape and contours of your bony jaw angles now. That would help make the determination as to the best approach to your jaw angle augmentation needs now. By your history with the bone grafts, this would indicate that you only need a widening jaw angle implant approach.
Dr. Barry Eppley