Jaw Angle Implants
Q: Dr. Eppley, I recently had jaw angle implants and the implants used were a medium sized lateral jaw angle implants. I can tell the implant does what it is supposed to do and looks good, but I’m afraid the Doctor placed the implant forward of where it should be. I can send you photos. The problem is that this is the 2nd time I’ve done this procedure with this Doctor. Last year we used a posterior angle implant and the result was quite bad. I thought it was because we used the wrong style of implant and should have gone with the lateral implant. However, I now realize that it was because that implant was also not placed correctly. I can’t imagine that a Doctor would intentionally misplace an implant, or that the doctor wouldn’t know where to correctly place the implant. Either way I am not comfortable seeing this Doctor anymore. I found your website and see that you are an expert on jaw augmentation. I am able to travel to Indiana. Are you able to fix my situation by simply going in and creating a new pocket for the implant to correctly place it, or would you have to use a new implant?
A: Thank you for your inquiry and I am sorry to hear of your lack of ideal results on your jaw angle implant surgeries. I do not believe your doctor intentionally misplaced the implants but jaw angle implants are the hardest facial implant to get positioned properly and in a symmetrical fashion. Releasing the tendinous muscular attachments can be difficult and is the key to proper jaw angle implant placement in most cases. Even with proper pocket development and implant placement if they are not secured with screws malposition is highly possible. Since there is so little different between Implantech’s posterior and lateral jaw angle implant styles, you are undoubtably correct in that implant positioning is the issue not the implant style. (as you have discovered after the second surgery)
If the jaw angle implants are providing the proper width increase in the jaw angles and are malpositioned anteriorly then repositioning and screw fixation would be the corrective approach. I obviously have no way of knowing where your jaw angle implants are and would prefer not to presume or guess where they may be. It would be ideal if we knew exactly where they were on the bone and this would best be determined by a 3D CT scan. That would provide unequivocal knowledge as to where they are and how far off from the ideal position on the jaw angles they may or may not be.
Dr. Barry Eppley