Q: Dr. Eppley, I had a Medpor Lateral Augmentation Onlay Mandible Angle Implant for mandibular augmentation about nine months ago. While I am satisfied with the results, I desire more lateral augmentation of his mandible. I know from reading that it is possible to reduce Medpor Implants in a second operation if the patient feels the implant provides too much augmentation. Is it also possible to enhance an implanted Medpor implant, by placing some further Medpor material on top of the implant surface in a second operation? I thought it could be useful to place smaller pieces from Medpor sheets and place and secure (screw) them over the existing mandibular implants in order to increase their lateral projection. Would you advise to place additional Medpor over an incorporated Medpor implant? Do you know if Medpor is designed for this or are there any problems that might occur by enhancing an existing Medpor implant with further Medpor material? Thank you in advance for your efforts.
A: I see no problem why you can’t add more material on top of an existing Medpor implant. The important issue would be good security (screw fixation) to the underlying implant. I would be concerned about shifting or palpability of a multi-implant reconstruction not any interactive material problem or reaction.
It would be far better and easier, I think, to remove the existing implant and add to it on the back table…to assemble a good solid construct and then re-insert during the surgery. This may make it surgically easier to do. Or why not change just to a whole new bigger implant and be assured you have a solid one-piece construction?