Secondary Jaw Angle Implant Overlays

Q: Dr. Eppley, I recently got Medpor jaw angle implants (1 month ago) 7.5 mm but already I wish I had went larger to the 1cm ones to have more flare. Would it be possible say in a year or so time to place a small custom silicone implant over the polyethylene implant without removal , and if not what would the reasons be.

A: You are referring to the concept of a jaw angle implant overlay. It can be technically done but would require lag screw fixation to they underlying implant to prevent impact migration. The best jaw angle implant to use for that effect would be the vertical lengthening style.

The only potential downside is the risk of massteric muscle disinsertion as it would be necessary to break through the overlying capsule to get the overlay implant down over the existing jaw angle implant. But I have done it more than once successfully.

Dr. Barry Eppley

Indianapolis, Indiana