Jaw Angle Implants after Hydroxyapatite Augmentation

Q: Dr. Eppley, I had a jaw angle augmentation done with hydroxyapatite granules at the end of last year. While the outcome produced some improvement, I have a very short lower jaw and I am looking for anbetter solution to vertically lengthening my jaw angles.

The question is in the case if I would like to have an operation with you shall I remove the hydroxyapatite granules which might be difficult or you can put implants on top of the hydroxyapatitite? I should mention that the maximum projection on the jaw angle is just 2.0mm.

A:You would need to augment your jaw angles with implants on top of the hydroxyapatite granules as they are very difficult to remove and have bone growth throughout them at this point. Given what is probably some asymmetry induced by the granules this raises the question of whether standard vs custom jaw angle implants would be needed. One approach is t burr down any irregular jaw angle surfaces and place standard vertically lengthening jaw angle implants, The other option is to have custom jaw angle implants made to account for any asymmetry and irregular bone surfaces caused by the hydroxyapatite granules. 

Dr. Barry Eppley

Indianapolis, Indiana