Q: Dr. Eppley, Could one have a custom made implant for the chin based on a facial casting to set up a mold for a bone paste like kryptonite. The theory here is that if the implant is a perfect fit then the paste will be a fit perfect too. To clarify… The paste would need to be pressed into the custom mold to set up the shape and then inserted into a ready pocket created with the help of the solid implant. You would avoid the blind aspect of shaping from the outside and complete the critical portion within the 4 minutes allotted to hardening.
A: Your thoughts are good ones but is limited by one major factor. Kryptonite is no longer commercially available (for reasons I do not know) and this is the only calcium-based bone cement that has the biomechanical properties to be molded and inserted similar to a solid implant. The other issue is that bone cements, even if preformed, are not flexible so intimate adaptation to the underlying bone may not occur. This could create some rocking and movement of such a custom made chin implant afterwards.
Dr. Barry Eppley