Screw Fixation of Custom Jawline Implant

Q: Dr. Eppley, I have three questions regarding the titanium screws for may custom jawline implant.

1.  Are they custom-made to different lengths, since they will be penetrating at three different spots of varying thickness along the mandible?  (Ie. 14mm/12mm at the gonial angle, ?mm at middle of mandible, and 4mm at chin, so they don’t over-penetrate or under-penetrate)

2.  Is there a torque limiter on your drill to prevent fracturing the bone?

3.  Can we place the six screws as follows?(on pages 6 and 7 of the pdf file below, which I have marked up)

A: In answer to your screw fixation questions for your custom jawline implant:

1) These are 1.6mm diameter self-drilling screws whose maximal length is 8mms. They are placed through portions of the implant were it is thinnest to accommodate the screw lengths.

2) These screws are smaller in size than Abraham Lincoln’s jaw on a penny. Thus the risk of bone fracture is not a concern.

3) All of the potential screws locations you have indicated are not viable options as either the implant is too thick or there is no point of access to do it. (center one) I have attached an imaging picture of what are the locations that can be used based on implant thickness and available screw lengths.

Dr. Barry Eppley
Indianapolis, Indiana